Trial reportPediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2016
Intraoperative Steroid Use and Outcomes Following the Norwood Procedure: An Analysis of the Pediatric Heart Network's Public Database.
Trial report in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Perioperative Corticosteroid Therapy in Children Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2020Pooled it
- Corticosteroid Therapy in Neonates Undergoing Cardiopulmonary Bypass: Randomized Controlled Trial.Journal of the American College of Cardiology · 2019Trial
- Trial
- Children with single ventricle heart disease have a greater increase in sRAGE after cardiopulmonary bypass.Perfusion · 2024Observational
- Methylprednisolone in Pediatric Cardiac Surgery: Is There Enough Evidence?Frontiers in cardiovascular medicine · 2021Review
- Glucocorticoid Receptor Polymorphisms in Children Undergoing Congenital Heart Surgery with Cardiopulmonary Bypass.Journal of pediatric intensive care · 2020Article
- Rationale and design of the STeroids to REduce Systemic inflammation after infant heart Surgery (STRESS) trial.American heart journal · 2020Article
- Article
- Pharmacological interventions for the prevention of acute kidney injury after pediatric cardiac surgery: a network meta-analysis.Clinical and experimental nephrology · 2019Article
- Steroids in paediatric heart surgery: eminence or evidence-based practice?Indian journal of thoracic and cardiovascular surgery · 2018Article
- Cardiopulmonary bypass for pediatric cardiac surgery.General thoracic and cardiovascular surgery · 2018Review
- Corticosteroids in Pediatric Heart Surgery: Myth or Reality.Frontiers in pediatrics · 2018Review
- Perioperative use of steroids in neonatal heart surgery: Evidence based practice or tradition?Annals of medicine and surgery (2012) · 2016Article
- The author replies.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2016Article
- Predicting Acute Kidney Injury After Pediatric Cardiac Surgery: Are Steroids Muddying the Water?Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveData supporting the use of perioperative steroids during cardiac surgery are conflicting, and most pediatric studies have been limited by small sample sizes and/or diverse cardiac diagnoses. The objective of this study was to determine if intraoperative steroid administration improved outcomes following the Norwood procedure.
designA retrospective analysis was performed on the 549 neonates who underwent a Norwood procedure in the publicly available datasets from the Pediatric Heart Network's Single Ventricle Reconstruction trial. Groups were compared to determine if outcomes differed between intraoperative steroid recipients (n = 498, 91%) and nonrecipients (n = 51, 9%).
settingFifteen North American centers. SUBJECTS: Infants enrolled in the Single Ventricle Reconstruction trial.
interventionsNone. MEASUREMENTS AND MAIN
resultsBaseline characteristics and intraoperative variables were similar between groups with the exception of a shorter duration of cross clamp and cardiopulmonary bypass time in the group that received steroids. Subjects who did not receive intraoperative steroids had improved hospital survival (94% vs 83%, p = 0.03) but longer ICU stays (16 d; interquartile range, 12-33 vs 14 d; interquartile range, 9-28; p = 0.04) and hospital stays (29 d; interquartile range, 21-50 vs 23 d; interquartile range, 15-40; p = 0.01) than steroid recipients. In multivariate analysis, lengths of stay associations were no longer significant, but hospital survival trended toward favoring the nonsteroid group with an odds ratio of 3.52 (95% CI, 0.98-12.64; p = 0.054).
conclusionsIn the large multicentered Single Ventricle Reconstruction trial, there was widespread use of intraoperative steroids. Intraoperative steroid administration was not associated with an improvement in outcomes and may be associated with a reduction in hospital survival in neonates undergoing the Norwood procedure. This study highlights the need for a randomized control trial.
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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.