Effect of low-dose dexamethasone on extra vascular lung water in patients following on-pump elective primary coronary artery bypass graft surgery

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dc.contributor.authorMaddali, Madan Mohanen_US
dc.contributor.authorWaje, Niranjan Dilipen_US
dc.contributor.authorArora, Nishant Ramen_US
dc.contributor.authorPanchatcharam, Sathiya Murthien_US
dc.date.accessioned2019-12-02T09:44:32Z
dc.date.available2019-12-02T09:44:32Z
dc.date.issued2019-10
dc.description.abstractBackground: The primary objective was to compare the effect of a low-dose dexamethasone as against a saline placebo on extravascular lung water index (EVLWI) in patients undergoing elective primary coronary artery bypass surgery. The secondary endpoints were to assess the effect of dexamethasone on other volumetric parameters (pulmonary vascular permeability index, global end diastolic volume index, and intrathoracic blood volume index), Vasoactive Inotrope Scores, hemodynamic parameters and serum osmolality in both groups. Settings and Design: Prospective observational study performed at a single tertiary cardiac care center. Materials and Methods: Twenty patients were randomized to receive either dexamethasone (steroid group, n = 10) or placebo (nonsteroid group, n = 10) twice before the institution of cardiopulmonary bypass (CPB). EVLWI and other volumetric parameters were obtained with the help of VolumeView™ Combo Kit connected to EV 1000 clinical platform at predetermined intervals. Hemodynamic parameters, vasoactive-inotropic Scores, hematocrit values were recorded at the predetermined time intervals. Baseline and 1st postoperative day serum osmolality values were also obtained. Results: The two groups were evenly matched in terms of demographic and CPB data. Intra- and inter-group comparison of the baseline EVLWI including other volumetric and hemodynamic parameters with those recorded at subsequent intervals revealed no statistical difference and was similar. Generalized estimating equation model was obtained to compare the changes between the groups over the entire study period which showed that on an average the changes between the steroid and nonsteroid group in terms of all volumetric parameters were not statistically significant. Conclusions: There were no beneficial effects of low-dose dexamethasone on EVLWI or other volumetric parameters in patients subjected to on-pump primary coronary bypass surgery. Hemodynamic parameters were also not affected. Probably, the advanced hemodynamic monitoring aided in optimal fluid management in the nonsteroidal group impacting EVLW accumulation.en_US
dc.identifier.affiliationsDepartment of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Omanen_US
dc.identifier.affiliationsDepartment of Studies and Research, Oman Medical Specialty Board, Muscat, Omanen_US
dc.identifier.citationMaddali Madan Mohan, Waje Niranjan Dilip, Arora Nishant Ram, Panchatcharam Sathiya Murthi. Effect of low-dose dexamethasone on extra vascular lung water in patients following on-pump elective primary coronary artery bypass graft surgery. Annals of Cardiac Anaesthesia. 2019 Oct; 22(4): 372-378en_US
dc.identifier.issn0971-9784
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/185869
dc.languageenen_US
dc.publisherWolters Kluwer - Medknowen_US
dc.relation.issuenumber4en_US
dc.relation.volume22en_US
dc.source.urihttps://dx.doi.org/10.4103/aca.ACA_122_18en_US
dc.subjectAnti‑inflammatory agents/pharmacologyen_US
dc.subjectdexamethasone/administration and dosageen_US
dc.subjectextravascular lung wateren_US
dc.subjectheart diseases/surgeryen_US
dc.subjectinflammation/prevention and controlen_US
dc.titleEffect of low-dose dexamethasone on extra vascular lung water in patients following on-pump elective primary coronary artery bypass graft surgeryen_US
dc.typeJournal Articleen_US
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