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

*Corresponding author for this work

Research output: Contribution to journalArticle

68 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Checchia, P. A., Backer, C. L., Bronicki, R. A., Baden, H. P., Crawford, S. E., Green, T. P., & Mavroudis, C. (2003). Dexamethasone reduces postoperative troponin levels in children undergoing cardiopulmonary bypass. Critical care medicine, 31(6), 1742-1745. https://doi.org/10.1097/01.CCM.0000063443.32874.60