EJMS

Abstract

Background: Respiratory failure is common and serious complication in the postoperative period after open heart surgeries. Methylprednisolone, a glucocorticoid, has anti-inflammatory effects, which may help to improve the patients’ responses and outcomes after this type of surgeries. Aim: The aim of this study was to evaluate the effects of methylprednisolone on inflammatory markers [C reactive protein (CRP) and interleukin 6 (IL-6)] and patients' outcomes in acute respiratory failure after open heart surgeries. Patients and Methods: Prospective, randomized, double blinded and controlled study design was used. Forty patients scheduled for open heart surgery were divided into two equal groups as follows: Group I (which received the usual post operative treatment) and Group II (which received 1 mg/kg methylprednisolone in addition to the usual post operative treatment). C reactive protein and interleukin 6 were measured in serum and comparison of change of their levels between both groups was recorded. Results: Demographic data, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACH II) score and lung injury score (LIS) were comparable in the two groups at day of study with insignificant difference. LIS significantly improved at day 7 in Group II than Group I. CRP significantly declined in the 7th day in comparison with 3rd day in each group and IL-6 significantly declined in each group from 3rd to 7th day with significant declinement in patients taken methylprednisolone at the 7th day when compared with the other group. intensive care unit (ICU) stay duration was not different between patients who take and didn't take methylprednisolone. Conclusion: From results of the current study, we conclude that methylprednisolone infusion was related to significant improvement in clinical outcome after seven days from open heart surgeries. In addition, methylprednisolone decreased inflammation in patients evidenced by significant decline in IL-6 level at the 7th day with improvement of overall patients' outcome.