Scientists Investigate Effect of Corticosteroid Hormones on Heart Surgery in Children

Russian scientists were part of an international team that conducted a study on the role of corticosteroid hormones (dexamethasone) on complications and mortality in children undergoing surgery for congenital heart defects. The study involved 394 children under the age of one.
The results were published in a leading medical journal, “The Journal of the American Medical Association” (JAMA). The Journal has an impact factor of 51.3. Vladimir Lomivorotov, one of the article’s authors, is a Professor at the mirror Anesthesiology and Resuscitation Division at NSU’s V. Zelman Institute of Medicine and Psychology, Head of the Meshalkin Center of Anesthesiology and Resuscitation, and Corresponding Member of the Russian Academy of Sciences.

Steroid drugs (including dexamethasone) have been widely used in medicine for over 60 years to reduce excessive activity in the immune system. With various diseases, this activity can damage human body systems.

Patients were identified from 2015 to 2018 in four clinics located in Russia, Brazil, and China during the DECISION research project. 394 patients took part in the study: 194 patients were administered a 1 mg / kg dose of dexamethasone and 200 patients received a placebo (control group). 38.1%, of the dexamethasone group and 45.5% of the control group developed serious complications (differences between the groups were not significant).

Using the results of an international clinical study, scientists demonstrated that the use of dexamethasone does not yield a decrease in postoperative complications and mortality in operations on children under the age of 12 months with congenital heart defects and cardiopulmonary bypass conditions. Scientists concluded that the use of this drug, which can also cause serious complications, is not recommended in pediatric heart surgery.

Lomivorotov talked about the article’s value,

The publication of the study results will allow many centers to abandon the routine use of steroid hormones in the treatment of congenital heart defects. Today, most centers in the world regularly use them. I would especially like to note that in medicine, the negative result of a study (the absence of differences between the groups or even the harm from the drug under review or technology) is of great importance because it allows you to abandon interventions that have not shown their clinical effectiveness.

Earlier studies in cardiac surgery conducted on smaller samples of patients with congenital heart defects indicated that the use of corticosteroids can improve the function of internal organs.