Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, clc.24018. https://doi.org/10.1002/clc.24018 Dr. Daliu Chen et al.
Points
- The impact of perioperative corticosteroids on mortality and clinical outcomes in pediatric cardiac surgery remains uncertain.
- A systematic review and meta-analysis analyzed ten randomized controlled trials involving 7798 children undergoing cardiac surgery with cardiopulmonary bypass.
- Corticosteroid use did not significantly affect all-cause in-hospital mortality compared to other therapies, placebo, or no treatment.
- However, corticosteroid administration was associated with reduced hospitalization duration compared to placebo.
- Further research with larger sample sizes is needed to obtain more conclusive evidence on the role of corticosteroids in pediatric cardiac surgery.
Summary
This research paper presents a systematic review and meta-analysis to investigate the impact of perioperative corticosteroid use on mortality and clinical outcomes in pediatric cardiac surgery with cardiopulmonary bypass (CPB). The study analyzed ten randomized controlled trials involving 7798 children aged 0–18 undergoing cardiac surgery, comparing perioperative corticosteroids with other therapeutic approaches, placebo, or no treatment. The primary endpoint was all-cause hospital mortality, while hospitalization duration was a secondary outcome. The analysis revealed that corticosteroid administration did not show a significant difference in all-cause in-hospital mortality compared to other therapies, placebo, or no treatment. However, it did demonstrate a reduction in hospitalization duration compared to placebo.
This study’s findings suggest that using perioperative corticosteroids may not significantly improve mortality outcomes in pediatric cardiac surgery patients. While the meta-analysis did not reveal a significant difference in all-cause in-hospital mortality, it did highlight a reduction in hospital stay when corticosteroids were administered. The results underscore the need for further research with larger sample sizes to obtain more conclusive evidence regarding the impact of corticosteroids in this patient population.
In conclusion, this systematic review and meta-analysis contribute to the ongoing discussion on the role of perioperative corticosteroids in pediatric cardiac surgery. While the findings suggest that corticosteroids may not improve mortality outcomes, they indicate a potential benefit in terms of reduced hospital stay compared to placebo. However, the limitations of the included studies and the heterogeneity observed in the analysis warrant the need for more robust randomized controlled trials to establish a definitive conclusion.
Link to the article: https://onlinelibrary.wiley.com/doi/full/10.1002/clc.24018
References Chen, D., & Du, Y. (2023). Analysis of perioperative corticosteroid therapy in children undergoing cardiac surgery: A systematic review and meta‐analysis. Clinical Cardiology, clc.24018. https://doi.org/10.1002/clc.24018
