An observational study of glucocorticoids in neonates undergoing cardiopulmonary bypass

Wang Jialu; Miao Na; Zhao Ju

doi:10.13498/j.cnki.chin.j.ecc.2024.06.06

Abstract：Objective This study aims to compare the effects of three different glucocorticoid strategies during CPB in neonates,and to compare the differences in in-hospital outcomes. Methods This study was an observational study. Neonates who underwent cardiac surgery with CPB in our center from April 2023 to July 2023 were enrolled. The patients were divided into three groups according to the strategy of methylprednisolone use during CPB:Group A received 15 mg/kg at the initiation of CPB and 15 mg/kg at rewarming,Group B received 30 mg/kg at rewarming,and Group C received 15 mg/kg at rewarming. The differences in primary and secondary outcomes among the three groups during hospitalization were compared. Results A total of 30 neonates undergoing CPB were enrolled in this study,including 11 (36.7％) in group A,9 (30％) in group B,and 10 (33.3％) in group C. In terms of the primary outcome,the incidences of the composite endpoint were similar among the three groups (45.5％ vs. 44.4％ vs. 50％,P>0.05). Specifically,the all-cause mortality rates were 9.1％ vs. 0％ vs. 0％;The incidences of acute kidney injury were 18.2％ vs. 33.3％ vs. 20％;The incidences of acute liver damage was 18.2％ vs. 0％ vs. 0％;the incidences of lactate elevation was 45.5％ vs. 11.1％ vs. 30％;the incidences of postoperative infections were 18.2％ vs. 22.2％ vs. 30％. None of these differences were statistically significant. Conclusion In neonatal cardiac surgery with CPB,there were no significant difference in the incidences of postoperative complications rates,the length of ICU stay and total hospital stay duration among the three different strategies of glucocorticoid administration.