ArticlePediatrics2012
Perioperative methylprednisolone and outcome in neonates undergoing heart surgery.
Article in Pediatrics, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 43 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Corticosteroid Therapy in Neonates Undergoing Cardiopulmonary Bypass
STeroids to REduce Systemic Inflammation After Infant Heart Surgery (STRESS)
Who cites it
43 citing papers in PubMed, 5 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- Methylprednisolone for heart surgery in pediatric patients: a meta-analysis of randomized trials.Scientific reports · 2026Pooled it
- Knowledge domains and hotspots in corticosteroid use for cardiac surgery: a 23-Year bibliometric and visualized analysis.Journal of cardiothoracic surgery · 2025Pooled it
- Analysis of perioperative corticosteroid therapy in children undergoing cardiac surgery: A systematic review and meta-analysis.Clinical cardiology · 2023Pooled it
- Prophylactic corticosteroids for paediatric heart surgery with cardiopulmonary bypass.The Cochrane database of systematic reviews · 2020Pooled it
- Perioperative Corticosteroid Therapy in Children Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2020Pooled it
- Trial
- Population Pharmacokinetic/Pharmacodynamic Modeling of Methylprednisolone in Neonates Undergoing Cardiopulmonary Bypass.CPT: pharmacometrics & systems pharmacology · 2019Trial
- Corticosteroid Therapy in Neonates Undergoing Cardiopulmonary Bypass: Randomized Controlled Trial.Journal of the American College of Cardiology · 2019Trial
- Intraoperative Steroid Use and Outcomes Following the Norwood Procedure: An Analysis of the Pediatric Heart Network's Public Database.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2016Trial
- Trial
- Preoperative steroid treatment does not improve markers of inflammation after cardiac surgery in neonates: results from a randomized trial.The Journal of thoracic and cardiovascular surgery · 2014Trial
- Evaluating Hospital Resource Utilization for Hypoplastic Left Heart Syndrome Through Linkage of a Clinical Registry and an Administrative Database.Pediatric cardiology · 2026Article
- Using Pharmacokinetic Modeling and Electronic Health Record Data to Predict Clinical and Safety Outcomes after Methylprednisolone Exposure during Cardiopulmonary Bypass in Neonates.Congenital heart disease · 2023Article
- Methylprednisolone in Pediatric Cardiac Surgery: Is There Enough Evidence?Frontiers in cardiovascular medicine · 2021Review
- Center Variation in Chest Tube Duration and Length of Stay After Congenital Heart Surgery.The Annals of thoracic surgery · 2020Article
- Rationale and design of the STeroids to REduce Systemic inflammation after infant heart Surgery (STRESS) trial.American heart journal · 2020Article
- Adrenal insufficiency in neonates undergoing cardiopulmonary bypass and postoperative hypothalamic-pituitary-adrenal function after prophylactic glucocorticoids.Journal of perinatology : official journal of the California Perinatal Association · 2019Observational
- Steroids in paediatric heart surgery: eminence or evidence-based practice?Indian journal of thoracic and cardiovascular surgery · 2018Article
- Resource Utilization in Pediatric Patients Supported With Ventricular Assist Devices in the United States: A Multicenter Study From the Pediatric Interagency Registry for Mechanically Assisted Circulatory Support and the Pediatric Health Information System.Journal of the American Heart Association · 2018Article
- Fluid overload independent of acute kidney injury predicts poor outcomes in neonates following congenital heart surgery.Pediatric nephrology (Berlin, Germany) · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundRecent studies have called into question the benefit of perioperative corticosteroids in children undergoing heart surgery, but have been limited by the lack of placebo control, limited power, and grouping of various steroid regimens together in analysis. We evaluated outcomes across methylprednisolone regimens versus no steroids in a large cohort of neonates.
methodsClinical data from the Society of Thoracic Surgeons Database were linked to medication data from the Pediatric Health Information Systems Database for neonates (≤30 days) undergoing heart surgery (2004-2008) at 25 participating centers. Multivariable analysis adjusting for patient and center characteristics, surgical risk category, and within-center clustering was used to evaluate the association of methylprednisolone regimen with outcome.
resultsA total of 3180 neonates were included: 22% received methylprednisolone on both the day before and day of surgery, 12% on the day before surgery only, and 28% on the day of surgery only; 38% did not receive any perioperative steroids. In multivariable analysis, there was no significant mortality or length-of-stay benefit associated with any methylprednisolone regimen versus no steroids, and no difference in postoperative infection. In subgroup analysis by surgical-risk group, there was a significant association of methylprednisolone with infection consistent across all regimens (overall odds ratio 2.6, 95% confidence interval 1.3-5.2) in the lower-surgical-risk group.
conclusionsThis multicenter observational analysis did not find any benefit associated with methylprednisolone in neonates undergoing heart surgery and suggested increased infection in certain subgroups. These data reinforce the need for a large randomized trial in this population.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.