N/A
N=190
Corticosteroid Therapy in Neonates Undergoing Cardiopulmonary Bypass
Congenital Heart Disease · Disorder of Fetus or Newborn
Bottom Line
View on ClinicalTrials.gov: NCT01579513 ↗Enrolled (actual)
190
Serious AEs
8.5%
Results posted
Jun 2019
Primary outcome: Primary: Number of Participants With a Clinically Derived Composite Morbidity-mortality Outcome — 27; 40 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Methylprednisolone (Drug); Placebo (Drug)
- Age
- Pediatric
- Sex
- All
- Sponsor
- Medical University of South Carolina
- Primary completion
- May 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With a Clinically Derived Composite Morbidity-mortality Outcome |
27; 40 | — |
| SECONDARY Duration of Mechanical Ventilation Post Cardiac Surgery. |
4; 5 | — |
| SECONDARY Intensive Care Unit Stay |
11; 11 | — |
| SECONDARY Hospital Stay |
20; 22 | — |
| SECONDARY Neurodevelopmental Outcome |
105; 104; 101; 100; 90; 91 | — |
Summary
Although cardiopulmonary bypass (heart-lung machine) is a necessary component of heart surgery, it is not without consequences. Cardiopulmonary bypass initiates a potent inflammatory response secondary to the body's recognition of the abnormal environment of the heart-lung machine. This inflammatory response may lead to poor heart, lung and kidney function after the heart surgery. This is turn can lead to longer times on the ventilator (breathing machine), the need for higher doses of heart medications, a longer stay in the intensive care unit and even death. This is particularly true in infants less than one month of age due to their size and the immaturity of their organs. The appreciation of the post-cardiopulmonary bypass inflammatory response has resulted in a number of interventions directed at its reduction. No therapy has been recognized as the standard of care; however steroid therapy has been applied most often despite unclear evidence of a benefit. This study aims to determine if steroids improve the outcomes of babies undergoing heart surgery.
Eligibility Criteria
Inclusion Criteria
- Age < 1 month
- Male and female patients who are scheduled to undergo cardiac surgery involving CPB
Exclusion Criteria
- Prematurity: < 37 weeks post gestational age at time of surgery
- Treatment with intravenous steroids within the two days prior to scheduled surgery.
- Participation in research studies involving the evaluation of investigational drugs within 30 days of randomization.
- Suspected infection that would contraindicate steroid use (eg - Herpes)
- Known hypersensitivity to IVMP or one of its components or other contraindication to steroid therapy (eg - gastrointestinal bleeding).
- Preoperative use of mechanical circulatory support or active resuscitation at the time of proposed randomization.
Data sourced from ClinicalTrials.gov (NCT01579513). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.