ArticleAmerican heart journal2020
Rationale and design of the STeroids to REduce Systemic inflammation after infant heart Surgery (STRESS) trial.
Article in American heart journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 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.
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, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- 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
- Reexploring the STRESS Trial: Subgroup Postoperative Outcomes Following Methylprednisolone for Infant Heart Surgery.Pediatric cardiology · 2026Trial
- A Bayesian re-analysis of the STRESS trial.American heart journal · 2026Trial
- Methylprednisolone for Infant Heart Surgery: Subpopulation Analyses of a Randomized Controlled Trial.Critical care medicine · 2025Trial
- Methylprednisolone for Heart Surgery in Infants - A Randomized, Controlled Trial.The New England journal of medicine · 2022Trial
- Prophylactic Methylprednisolone in Neonatal On-Pump Cardiac Surgery.Reviews in cardiovascular medicine · 2026Article
- Population Pharmacokinetics of Caffeine in Neonates with Congenital Heart Disease and Associations with Acute Kidney Injury.Journal of clinical pharmacology · 2024Article
- Association of Urine Biomarkers With Acute Kidney Injury and Fluid Overload in Infants After Cardiac Surgery: A Single Center Ancillary Cohort of the Steroids to Reduce Systemic Inflammation After Infant Heart Surgery Trial.Critical care explorations · 2023Article
- 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
- Born to Age: When Adult Congenital Heart Disease Converges With Geroscience.JACC. Advances · 2022Review
- Pediatric Perioperative Clinical Pharmacy Practice: Clinical Considerations and Management: An Opinion of the Pediatrics and Perioperative Care Practice and Research Networks of the American College of Clinical Pharmacy.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- Identifying Risk Factors for Complicated Post-operative Course in Tetralogy of Fallot Using a Machine Learning Approach.Frontiers in cardiovascular medicine · 2021Article
- Methylprednisolone in Pediatric Cardiac Surgery: Is There Enough Evidence?Frontiers in cardiovascular medicine · 2021Review
- Registry-based trials: a potential model for cost savings?Cardiology in the young · 2020Article
Corrections and comments
- Commented on by
Authors and funding
18 authors at 8 institutions in 1 country.
Funding
Abstract
For decades, physicians have administered corticosteroids in the perioperative period to infants undergoing heart surgery with cardiopulmonary bypass (CPB) to reduce the postoperative systemic inflammatory response to CPB. Some question this practice because steroid efficacy has not been conclusively demonstrated and because some studies indicate that steroids could have harmful effects. STRESS is a randomized, placebo-controlled, double-blind, multicenter trial designed to evaluate safety and efficacy of perioperative steroids in infants (age < 1 year) undergoing heart surgery with CPB. Participants (planned enrollment = 1,200) are randomized 1:1 to methylprednisolone (30 mg/kg) administered into the CPB pump prime versus placebo. The trial is nested within the existing infrastructure of the Society of Thoracic Surgeons Congenital Heart Surgery Database. The primary outcome is a global rank score of mortality, major morbidities, and hospital length of stay with components ranked commensurate with their clinical severity. Secondary outcomes include several measures of major postoperative morbidity, postoperative hospital length of stay, and steroid-related safety outcomes including prevalence of hyperglycemia and postoperative infectious complications. STRESS will be one of the largest trials ever conducted in children with heart disease and will answer a decades-old question related to safety and efficacy of perioperative steroids in infants undergoing heart surgery with CPB. The pragmatic "trial within a registry" design may provide a mechanism for conducting low-cost, high-efficiency trials in a heretofore-understudied patient population.
Indexed as
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.