Most Read Articles
11 Oct 2019
Blood transfusion occurs with a striking frequency among autologous breast reconstruction patients and is associated with an increased risk of surgery-related complications, a recent study has found.
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Tristan Manalac, 25 Aug 2017
Using blunt needles to administer local anaesthesia in upper blepharoplasty has a lower risk of haemorrhage and need for interventional pain procedures compared with sharp needles, a new randomized clinical trial has found.
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Prophylactic methylprednisolone may benefit some neonates undergoing cardiac surgery

11 Aug 2019

Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.

However, patients undergoing palliative procedures seem to benefit from corticosteroid therapy. In addition, a significant interaction exists between treatment effect and centre, suggesting the possibility of centre or patient characteristics that make prophylactic methylprednisolone helpful.

This double-blind randomized controlled trial determined whether intraoperative methylprednisolone improved postoperative recovery in neonate undergoing cardiac surgery. The investigators enrolled 190 neonates undergoing cardiopulmonary bypass at two centres after the induction of anaesthesia, among whom 176 (n=81 methylprednisolone 30 mg/kg; n=95 placebo) were included in the analysis.

The primary endpoint was a previously validated morbidity-mortality composite of any of the following events after surgery before discharge: death, cardiac arrest, hepatic injury, renal injury, mechanical circulatory support or rising lactate level (>5 mmol/l).

These outcomes occurred in 27 (33 percent) neonates in the methylprednisolone group and 40 (42 percent) in the placebo group (odds ratio [OR], 0.63, 95 percent CI, 0.31–1.3; p=0.21). However, methylprednisolone led to decreases in vasoactive inotropic requirement and in the incidence of the composite endpoint in patients undergoing palliative operations (OR, 0.38, 0.15–0.99; p=0.048).

Furthermore, a significant interaction was observed between treatment effect and centre in this analysis. Corticosteroid therapy conferred a protective benefit at one centre (OR, 0.35, 0.15–0.84; p=0.02) but not at the other (OR, 5.13, 0.85–30.90; p=0.07).

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Most Read Articles
11 Oct 2019
Blood transfusion occurs with a striking frequency among autologous breast reconstruction patients and is associated with an increased risk of surgery-related complications, a recent study has found.
05 Nov 2019
Low total cholesterol levels appear to carry increased major adverse cardiovascular events (MACE) hazard in older men without ischaemic heart disease (IHD) and not receiving statin therapy but not to those on statins, according to data from the CHAMP (Concord Health and Ageing in Men Project) cohort.
Tristan Manalac, 25 Aug 2017
Using blunt needles to administer local anaesthesia in upper blepharoplasty has a lower risk of haemorrhage and need for interventional pain procedures compared with sharp needles, a new randomized clinical trial has found.
09 Nov 2019
In patients with acute ST-segment elevation myocardial infarction (ASTEMI), the risk of new-onset atrial fibrillation (NOAF) appears to be linked with plasma levels of low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC), a recent China study has found.