生まれながらの心臓外科手術の併用ステロイド治療は,酸素の供給を改善し,バイパス後の炎症媒介者の発現を減少させます
Valerie A Schroeder1, Jeffery M Pearl, Steven M Schwartz
1Division of Cardiology, Cincinnati Children's Hospital, Cincinnati, Ohio, USA.
Circulation
|May 21, 2003
まとめ
心臓バイパス手術の前およびその間ステロイドの投与は,小児患者の炎症を軽減し,酸素の供給を改善します. この組み合わせのアプローチは,手術中にステロイドのみを使用するよりも,より良い結果を示しています.
科学分野:
- 心血管外科手術についてです.
- ペディアトリック・カルディオロジー
- 免疫学 免疫学とは
背景:
- ステロイドは,心肺バイパス中の炎症を軽減することができます.
- この研究では,手術前および手術中のメチルプレドニソロン (MP) と,手術中のMPのみを比較しています.
研究 の 目的:
- 術前および手術中のMPを併用して,手術中のMP単独で投与する効果を比較する.
- バイパス後の炎症と小児患者の臨床結果への影響を評価する.
主な方法:
- バイパス手術を受けた29人の小児患者のランダム化試験.
- 心筋炎症媒介者mRNAと血清サイトカイン (IL-6,IL-10) を測定した.
- 挿管時間,ICU滞在,および液体バランスを含む臨床的アウトカムを評価.
主要な成果:
- 組み合わせたMPは,IL-6,MCP-1,ICAM-1に対する心臓筋mRNA発現を低下させた.
- 併用MPを投与された患者は,バイパス後の血清IL-6が低下し,IL-10が増加した.
- 組み合わせたMPは,最初の24時間で流体要求の減少と酸素供給指数の改善に関連していました.
結論:
- 併用された手術前および手術中のステロイド投与は,炎症媒介体を減らすのにより効果的です.
- このアプローチは,先天性心臓手術後の早期の術後期に酸素の供給を改善します.
- これらの発見を確認するために,より大きな多センター試験が必要である.
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