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Related Experiment Video

Updated: Jul 9, 2026

Intratracheal Instillation of Stem Cells in Term Neonatal Rats
04:27

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Published on: May 4, 2020

Prophylactic Methylprednisolone in Neonatal On-Pump Cardiac Surgery.

Peng Gao1, Yu Jin2, He Wang3

  • 1Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100007 Beijing, China.

Reviews in Cardiovascular Medicine
|July 8, 2026
PubMed
Summary

Methylprednisolone (MP) reduced inflammation in neonates undergoing cardiac surgery but did not significantly improve clinical outcomes. This study assessed MP

Keywords:
cardiac surgerycardiopulmonary bypassclinical outcomecorticosteroidsinflammatory responseneonate

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Area of Science:

  • Pediatric Cardiac Surgery
  • Neonatal Critical Care
  • Pharmacology and Therapeutics

Background:

  • Corticosteroids, including methylprednisolone (MP), are frequently used in neonatal cardiac surgery to mitigate inflammation.
  • Perioperative MP administration has demonstrated potential in reducing the inflammatory response, yet its impact on postoperative clinical outcomes in neonates remains incompletely understood.
  • This study investigates the effects of MP on postoperative inflammation and clinical outcomes in neonates undergoing cardiopulmonary bypass (CPB) during cardiac surgery.

Purpose of the Study:

  • To evaluate the efficacy of prophylactic methylprednisolone (MP) in modulating postoperative inflammation in neonates undergoing cardiac surgery with cardiopulmonary bypass (CPB).
  • To assess the impact of MP on key postoperative clinical outcomes in this vulnerable patient population.

Main Methods:

  • A prospective, non-randomized, unblinded controlled trial involving 86 neonates undergoing cardiac surgery with CPB.
  • Participants received either a single 30 mg/kg dose of MP or an equivalent volume of saline solution (placebo) post-anesthesia induction.
  • Primary endpoints included plasma levels of interleukin (IL-6, IL-8, IL-10) and D-dimer; composite outcomes encompassed mortality, respiratory infection, cardiac arrest, ECMO requirement, AKI, low cardiac output syndrome, and prolonged mechanical ventilation.

Main Results:

  • MP administration significantly reduced pro-inflammatory cytokines (IL-6, IL-8) and increased anti-inflammatory cytokine (IL-10) levels.
  • No significant reduction in the composite outcome was observed (58.1% in MP group vs. 53.5% in placebo group, p=0.664).
  • The MP group exhibited a lower vasoactive-inotropic score, higher procalcitonin, and higher nadir mixed venous oxygen saturation within 24 hours postoperatively.

Conclusions:

  • Prophylactic methylprednisolone (MP) at 30 mg/kg did not lead to statistically significant improvements in clinical outcomes for neonates undergoing cardiac surgery with CPB.
  • The intervention effectively reduced the inflammatory response, as indicated by altered cytokine profiles.
  • Further research may be warranted to explore optimal dosing or alternative strategies for improving clinical outcomes in this setting.