Dexamethasone reduces postoperative troponin levels in children undergoing cardiopulmonary bypass

Paul A. Checchia, Carl L. Backer, Ronald A. Bronicki, Harris P. Baden, Susan E. Crawford, Thomas P. Green, Constantine Mavroudis

Research output: Contribution to journalArticle

Abstract

Objective: We previously demonstrated that dexamethasone treatment before cardiopulmonary bypass in children reduces the postoperative systemic inflammatory response. The purpose of this study was to test the hypothesis that dexamethasone administration before cardiopulmonary bypass in children correlates with a lesser degree of myocardial injury as measured by a decrease in cardiac troponin I release. Design: A prospective, randomized, double-blind study. Setting: The cardiac surgery operating room and intensive care unit of a pediatric referral hospital. Subjects: Twenty-eight patients who underwent open-heart surgery for congenital heart defects. Interventions: Patients received either placebo (group I, n = 13) or dexamethasone, 1 mg/kg iv (group II, n = 15), 1 hr before initiation of cardiopulmonary bypass. Plasma cardiac troponin I samples were obtained at three time points: immediately before study agent (sample 1), 10 mins after protamine sulfate administration after cardiopulmonary bypass (sample 2), and 24 hrs postoperatively (sample 3). Measurements and Main Results: Mean cardiac troponin I levels (±SD) were significantly lower at sample time 3 in group II (dexamethasone; 33.4 ± 20.0 ng/mL) vs. group I (control; 86.9 ± 81.1) (p = .04). Conclusion: Dexamethasone administration before cardiopulmonary bypass in children resulted in a significant decrease in cardiac troponin I levels at 24 hrs postoperatively. We postulate that this may represent a decrease in myocardial injury, and, thus, a possible cardioprotective effect produced by dexamethasone.

Original languageEnglish (US)
Pages (from-to)1742-1745
Number of pages4
JournalCritical Care Medicine
Volume31
Issue number6
DOIs
StatePublished - Jun 1 2003
Externally publishedYes

Fingerprint

Troponin
Cardiopulmonary Bypass
Dexamethasone
Troponin I
Thoracic Surgery
Pediatric Hospitals
Protamines
Congenital Heart Defects
Wounds and Injuries
Operating Rooms
Double-Blind Method
Intensive Care Units
Referral and Consultation
Placebos
Control Groups

Keywords

  • Cardiopulmonary bypass
  • Dexamethasone
  • Postcardiopulmonary bypass inflammatory response
  • Troponin

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Dexamethasone reduces postoperative troponin levels in children undergoing cardiopulmonary bypass. / Checchia, Paul A.; Backer, Carl L.; Bronicki, Ronald A.; Baden, Harris P.; Crawford, Susan E.; Green, Thomas P.; Mavroudis, Constantine.

In: Critical Care Medicine, Vol. 31, No. 6, 01.06.2003, p. 1742-1745.

Research output: Contribution to journalArticle

Checchia, Paul A. ; Backer, Carl L. ; Bronicki, Ronald A. ; Baden, Harris P. ; Crawford, Susan E. ; Green, Thomas P. ; Mavroudis, Constantine. / Dexamethasone reduces postoperative troponin levels in children undergoing cardiopulmonary bypass. In: Critical Care Medicine. 2003 ; Vol. 31, No. 6. pp. 1742-1745.
@article{593148fae82645048ce4a9866825ba59,
title = "Dexamethasone reduces postoperative troponin levels in children undergoing cardiopulmonary bypass",
abstract = "Objective: We previously demonstrated that dexamethasone treatment before cardiopulmonary bypass in children reduces the postoperative systemic inflammatory response. The purpose of this study was to test the hypothesis that dexamethasone administration before cardiopulmonary bypass in children correlates with a lesser degree of myocardial injury as measured by a decrease in cardiac troponin I release. Design: A prospective, randomized, double-blind study. Setting: The cardiac surgery operating room and intensive care unit of a pediatric referral hospital. Subjects: Twenty-eight patients who underwent open-heart surgery for congenital heart defects. Interventions: Patients received either placebo (group I, n = 13) or dexamethasone, 1 mg/kg iv (group II, n = 15), 1 hr before initiation of cardiopulmonary bypass. Plasma cardiac troponin I samples were obtained at three time points: immediately before study agent (sample 1), 10 mins after protamine sulfate administration after cardiopulmonary bypass (sample 2), and 24 hrs postoperatively (sample 3). Measurements and Main Results: Mean cardiac troponin I levels (±SD) were significantly lower at sample time 3 in group II (dexamethasone; 33.4 ± 20.0 ng/mL) vs. group I (control; 86.9 ± 81.1) (p = .04). Conclusion: Dexamethasone administration before cardiopulmonary bypass in children resulted in a significant decrease in cardiac troponin I levels at 24 hrs postoperatively. We postulate that this may represent a decrease in myocardial injury, and, thus, a possible cardioprotective effect produced by dexamethasone.",
keywords = "Cardiopulmonary bypass, Dexamethasone, Postcardiopulmonary bypass inflammatory response, Troponin",
author = "Checchia, {Paul A.} and Backer, {Carl L.} and Bronicki, {Ronald A.} and Baden, {Harris P.} and Crawford, {Susan E.} and Green, {Thomas P.} and Constantine Mavroudis",
year = "2003",
month = "6",
day = "1",
doi = "10.1097/01.CCM.0000063443.32874.60",
language = "English (US)",
volume = "31",
pages = "1742--1745",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Dexamethasone reduces postoperative troponin levels in children undergoing cardiopulmonary bypass

AU - Checchia, Paul A.

AU - Backer, Carl L.

AU - Bronicki, Ronald A.

AU - Baden, Harris P.

AU - Crawford, Susan E.

AU - Green, Thomas P.

AU - Mavroudis, Constantine

PY - 2003/6/1

Y1 - 2003/6/1

N2 - Objective: We previously demonstrated that dexamethasone treatment before cardiopulmonary bypass in children reduces the postoperative systemic inflammatory response. The purpose of this study was to test the hypothesis that dexamethasone administration before cardiopulmonary bypass in children correlates with a lesser degree of myocardial injury as measured by a decrease in cardiac troponin I release. Design: A prospective, randomized, double-blind study. Setting: The cardiac surgery operating room and intensive care unit of a pediatric referral hospital. Subjects: Twenty-eight patients who underwent open-heart surgery for congenital heart defects. Interventions: Patients received either placebo (group I, n = 13) or dexamethasone, 1 mg/kg iv (group II, n = 15), 1 hr before initiation of cardiopulmonary bypass. Plasma cardiac troponin I samples were obtained at three time points: immediately before study agent (sample 1), 10 mins after protamine sulfate administration after cardiopulmonary bypass (sample 2), and 24 hrs postoperatively (sample 3). Measurements and Main Results: Mean cardiac troponin I levels (±SD) were significantly lower at sample time 3 in group II (dexamethasone; 33.4 ± 20.0 ng/mL) vs. group I (control; 86.9 ± 81.1) (p = .04). Conclusion: Dexamethasone administration before cardiopulmonary bypass in children resulted in a significant decrease in cardiac troponin I levels at 24 hrs postoperatively. We postulate that this may represent a decrease in myocardial injury, and, thus, a possible cardioprotective effect produced by dexamethasone.

AB - Objective: We previously demonstrated that dexamethasone treatment before cardiopulmonary bypass in children reduces the postoperative systemic inflammatory response. The purpose of this study was to test the hypothesis that dexamethasone administration before cardiopulmonary bypass in children correlates with a lesser degree of myocardial injury as measured by a decrease in cardiac troponin I release. Design: A prospective, randomized, double-blind study. Setting: The cardiac surgery operating room and intensive care unit of a pediatric referral hospital. Subjects: Twenty-eight patients who underwent open-heart surgery for congenital heart defects. Interventions: Patients received either placebo (group I, n = 13) or dexamethasone, 1 mg/kg iv (group II, n = 15), 1 hr before initiation of cardiopulmonary bypass. Plasma cardiac troponin I samples were obtained at three time points: immediately before study agent (sample 1), 10 mins after protamine sulfate administration after cardiopulmonary bypass (sample 2), and 24 hrs postoperatively (sample 3). Measurements and Main Results: Mean cardiac troponin I levels (±SD) were significantly lower at sample time 3 in group II (dexamethasone; 33.4 ± 20.0 ng/mL) vs. group I (control; 86.9 ± 81.1) (p = .04). Conclusion: Dexamethasone administration before cardiopulmonary bypass in children resulted in a significant decrease in cardiac troponin I levels at 24 hrs postoperatively. We postulate that this may represent a decrease in myocardial injury, and, thus, a possible cardioprotective effect produced by dexamethasone.

KW - Cardiopulmonary bypass

KW - Dexamethasone

KW - Postcardiopulmonary bypass inflammatory response

KW - Troponin

UR - http://www.scopus.com/inward/record.url?scp=0038724162&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038724162&partnerID=8YFLogxK

U2 - 10.1097/01.CCM.0000063443.32874.60

DO - 10.1097/01.CCM.0000063443.32874.60

M3 - Article

C2 - 12794414

AN - SCOPUS:0038724162

VL - 31

SP - 1742

EP - 1745

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 6

ER -