The effect of hemofilter, preoperative and intraoperative methylprednisolone on complications after open heart surgery

Abstract

Complications after open heart surgery may threaten patient’s survival rate. The
intraoperative methylprednisolone administration alone shows controversial results
on open heart surgery complications. Similarly, the intraoperative and preoperative
methylprednisolone administration as well as the use of hemofilter in open heart surgery
is still controversial. This study aimed to evaluate the effect of hemofilter, preoperative
and intraoperative methylprednisolone administration on complications following open
heart surgery. This was a Prospective Randomized Open-Blinded Evaluation (PROBE)
experimental study. Ninety-five patients who had open heart surgery in Dr. Sardjito
General Hospital, Yogyakarta, and Integrated Cardiac Care of Dr. Cipto Mangunkusumo
General Hospital, Jakarta within the period of December 2011 to May 2012 were
involved in this study. The patients were divided into two groups i.e. group A, 48 patients
received methylprednisolone 15mg/kg intraoperatively, methylprednisolone 5mg/kg
preoperatively, and hemofilter, while group B, 47 patients received methylprednisolone
15mg/kg intraoperatively alone. From the total 95 patients, we found 26 (27.4%)
patients experienced complications i.e. 19 in group B (40.4%) and 7 in group A
(14.6%). The differences of the complications were statistically significant (p<0.05;
OR=3.97; 95%CI=1.476-10.71). Complications risk decreased by 63.9% in the group
A compared to the group B with the hazard ratio of 3.2. In conclusion, the application of
hemofilter, preoperative and intraoperative methylprednisolone might decrease the risk of
complications after open heart surgery.