Influence Of Steroid On Clinical Recovery And Inflammatory Response In Pediatric Patients Undergoing Cardiopulmonary Bypass

Abstract

Background: Due to surgical stress, ischemia-reperfusion damage, and blood contact with artificial surfaces, cardiopulmonary bypass (CPB) in pediatric heart surgery causes a major systemic inflammatory response. Postoperative problems delayed clinical recovery, prolonged breathing, and a lengthy stay in the intensive care unit (ICU) can all be attributed to this inflammatory cascade. Due to their anti-inflammatory qualities, hydrocortisone have been used extensively during surgery; nevertheless, there is conflicting information about their therapeutic value and their effect on inflammatory markers and clinical recovery in pediatric patients having CPB.

Objective(s): to assess the impact of intraoperative steroid treatment on inflammatory response and clinical recovery outcomes in pediatric patients receiving cardiopulmonary bypass.

Methodology: The study was a comparative, hospital-based study of pediatric patients undergoing elective cardiac surgery with cardiopulmonary bypass. 90 patients in total were included and randomized to a control group receiving standard treatment, and a steroid group receiving intraoperative hydrocortisone. Clinical recovery parameters were documented, including length of hospital stay, length of stay in the Intensive Care Unit and mechanical ventilation. The inflammatory response was assessed through laboratory markers such as the C-reactive protein (CRP) and total leukocyte count (TLC), pre and post surgery. Appropriate statistical tests were used to assess the data, and a p-value of less than 0.05 was deemed statistically significant.

Results: In comparison to the control group, patients who received perioperative steroids showed a decrease in postoperative inflammatory markers. Additionally, the steroid group demonstrated trends toward shorter ICU stays and mechanical ventilation durations, suggesting better early clinical recovery. Nonetheless, the two groups' overall hospital stays differed less.

Conclusion(s): In pediatric patients having cardiopulmonary bypass, intraoperative steroid treatment seems to reduce the postoperative inflammatory response and may enhance early clinical recovery. Even while there were clear biochemical advantages, the effect on significant clinical outcomes calls for more extensive, well-planned research to provide uniform steroid procedures in pediatric heart surgery.