International Symposium on the Pathophysiology of Cardiopulmonary Bypass
- Meeting abstract
Corticosteroids reduce early troponin-T release after cardiac surgery with cardiopulmonary bypass in men
Critical Care volume 3, Article number: P27 (1999)
To study whether administration of corticosteroids (CS) prior to cardiac surgery for coronary artery bypass grafting (CABG), can influence early troponin-T release after cardiac surgery with cardiopulmonary bypass (CPB).
Material and methods
Fifty-eight male patients with coronary artery disease undergoing programmed CABG with CPB were divided into five groups: Group 1 (Control; n = 10); Group 2 (methylprednisolone, (MPS) = 10 mg/kg, 4 h before CPB; n = 14); Group 3 (MPS = 10 mg/kg, at induction of anesthesia (IA); n = 10); Group 4 (MPS = 10 mg/kg, 12h before, as well as at IA; n = 10); Group 5 (MPS = 30 mg/kg 4 h before CPB; n = 14). CPB was conducted using a blood-free priming, a cold crystalloid cardioplegia and moderate hypothermia (29-30°C). Anesthesia consisted of continuous administration of midazolam, sufentanil and pancuronium. Aprotinin was not used. Plasmatic troponin-T levels were measured before induction of anesthesia (t0) and 4 h after CPB (t1) using specific ELISA.
There was no significant difference in age, weight, duration of CPB, aorta clamping time and number of grafts between groups (Table). Troponin-T values at t0 were similar in all patients. Troponin-T levels measured 4h after the end of CPB were similar in control (Group 1), Group 3, and Group 4. In contrast, troponin-T levels were significantly lower in the 2 groups receiving MPS 4h before CPB (Group 2: 10 mg/kg and Group 5: 30 mg/kg) as compared to controls (*P = 0.001 and **P = 0.0004, respectively). There was no significant difference in troponin-T levels between Group 2 and Group 5.
Pharmacological doses of CS significantly reduce early troponin-T release after CPB. The timing of CS administration plays an important role, as the treatment was effective when CS were given 4 h prior to CPB but not at the beginning of surgery. Doses of 10 mg/kg and 30 mg/kg are equally effective.
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Cite this article
Tabardel, Y., Schmartz, D., Leclerc, J. et al. Corticosteroids reduce early troponin-T release after cardiac surgery with cardiopulmonary bypass in men. Crit Care 3 (Suppl 2), P27 (1999). https://doi.org/10.1186/cc338