The effect of combination of hemofilter, pre- and intraoperative methylprednisolone administration on systemic inflammatory response syndrome (SIRS) post open heart surgery
Abstract: Systemic
inflammatory response syndrome (SIRS) occurs in almost all patients whom
undergo open heart surgery causes the increase its morbidity and mortality. The
effect of pre- and intraoperative methylprednisolone administration combined
with hemofilter application in cardiopulmonary bypass machine in the reduction
of SIRS incidence remains controversial. This study aimed to evaluate the
effect pre- and intraoperative methylprednisolone administration combined with
hemofilter on SIRS incidence after open heart surgery. This was an experimental
study using prospective randomized open-blinded evaluation (PROBE) design.
Ninety-five patients from Dr. Sardjito General Hospital, Yogyakarta, and Dr.
Cipto Mangunkusumo General Hospital, Jakarta, who had open heart surgery within
the period of December 2011 to May 2012 were enrolled in this study. The
patients were randomly allocated into two groups i.e. Group A (48 patients)
received pre-; intra-; and postoperative methylprednisolone (15; 5 and 5 mg/kg
BW, respectively) and hemofilter and Group B (47 patients) just received intra-
and postoperative methylprednisolone (15 and 5 mg/kg BW). The SIRS incidence
was evaluated in 3; 24; 48 and 72 hours post surgery. This study showed that
the SIRS incidence in Group B at 3 (OR= 0.12; 95%CI=0.03-0.39; p< 0.001) and
24 (OR= 0.38; 95%CI=0.14-0.996; p< 0.031) hours postoperative were
significantly higher than that in Group A. In conclusion, pre- and
intraoperative methylprednisolone administration combined hemofilter
significantly decrease the SIRS incidence post open heart surgery.
Author: Supomo
Journal Code: jpkedokterangg170288
