Prophylactic corticosteroids for cardiopulmonary bypass in adults

Pulmonary complications of cardiopulmonary bypass

“…Study results including small studies [111], Cochrane review [112] and large, multicenter international trials [113,114] have yielded mixed results, thus steroids are not currently indicated to reduce pulmonary complications. …”

Chronic glucocorticoids exposure enhances neurodegeneration in the frontal cortex and hippocampus via NLRP-1 inflammasome activation in male mice

“…The doses of DEX from 0.035 to 1 mg/kg were widely prescribed in clinic for treating many diseases (Dieleman et al, 2011;Din et al, 2015;Ottens et al, 2015), while the doses from 0.5 to 80 mg/kg, especially 5 mg/kg, were widely used in animals to study the neurodegenerative diseases (Danilczuk et al, 2005(Danilczuk et al, , 2006Green et al, 2006). Our previous studies showed that chronic stress (8 weeks) and DEX (5 mg/kg) treatment for 21 days induced learning and memory impairment and hippocampal neurodegeneration (Li et al, 2010;Wang et al, 2014).…”

Inflammatory response and extracorporeal circulation

“…Over decades, several clinical trials scrutinised the anti-inflammatory effect of glucocorticoids on major and minor outcome parameters in human patients. After several promising results in single-centre trials, a thorough meta-analysis revealed that the positive effects of glucocorticoid application were minor than initially thought [78]. There was no difference in major outcome parameters such as major cardiac events, pulmonary complications or mortality after 30 days.…”

“…The Steroids in Cardiac Surgery (SIRS) trial is a large international randomised controlled study that investigates the effects on AKI and other outcome parameters [81]. Nevertheless, until now, there has been no evidence for an effect of glucocorticoid administration on mortality or severe cardiac complications [78].…”