Lung Injury After Neonatal Congenital Cardiac Surgery Is Mild and Modifiable by Corticosteroids

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http://hdl.handle.net/10138/333102

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Kaskinen , A K , Keski-Nisula , J , Martelius , L , Moilanen , E , Hämäläinen , M , Rautiainen , P , Andersson , S & Pitkänen-Argillander , O M 2021 , ' Lung Injury After Neonatal Congenital Cardiac Surgery Is Mild and Modifiable by Corticosteroids ' , Journal of Cardiothoracic and Vascular Anesthesia , vol. 35 , no. 7 , pp. 2100-2107 . https://doi.org/10.1053/j.jvca.2021.01.017

Title: Lung Injury After Neonatal Congenital Cardiac Surgery Is Mild and Modifiable by Corticosteroids
Author: Kaskinen, Anu K.; Keski-Nisula, Juho; Martelius, Laura; Moilanen, Eeva; Hämäläinen, Mari; Rautiainen, Paula; Andersson, Sture; Pitkänen-Argillander, Olli M.
Contributor organization: Clinicum
HUS Children and Adolescents
Children's Hospital
University of Helsinki
HUS Medical Imaging Center
Department of Diagnostics and Therapeutics
Lastentautien yksikkö
Date: 2021-07
Language: eng
Number of pages: 8
Belongs to series: Journal of Cardiothoracic and Vascular Anesthesia
ISSN: 1053-0770
DOI: https://doi.org/10.1053/j.jvca.2021.01.017
URI: http://hdl.handle.net/10138/333102
Abstract: Objectives: The present study was performed to determine whether lung injury manifests as lung edema in neonates after congenital cardiac surgery and whether a stress-dose corticosteroid (SDC) regimen attenuates postoperative lung injury in neonates after congenital cardiac surgery. Design: A supplementary report of a randomized, double-blinded, placebo-controlled clinical trial. Setting: A pediatric tertiary university hospital. Participants: Forty neonates (age Measurements and Main Results: The chest radiography lung edema score was lower in the SDC than in the placebo group on the first postoperative day (POD one) (p = 0.03) and on PODs two and three (p = 0.03). Furthermore, a modest increase in the edema score of 0.9 was noted in the placebo group, whereas the edema score remained at the preoperative level in the SDC group. Postoperative dynamic respiratory system compliance was higher in the SDC group until POD three (p < 0.01). However, postoperative oxygenation; length of mechanical ventilation; and tracheal aspirate biomarkers of inflammation and oxidative stress, namely interleukin-6, interleukin-8, resistin, and 8-isoprostane, showed no differences between the groups. Conclusions: The SDC regimen reduced the development of mild and likely clinically insignificant radiographic lung edema and improved postoperative dynamic respiratory system compliance without adverse events, but it failed to improve postoperative oxygenation and length of mechanical ventilation. (C) 2021 The Authors. Published by Elsevier Inc.
Subject: lung injury
infant
glucocorticoid
congenital heart defect
pulmonary injury
pulmonary edema
cardiac surgery
RESPIRATORY-DISTRESS-SYNDROME
CARDIOPULMONARY BYPASS
INFLAMMATORY RESPONSE
PULMONARY-ATRESIA
METHYLPREDNISOLONE
TETRALOGY
STEROIDS
STRESS
DEXAMETHASONE
CHILDREN
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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