ArticleJournal of cardiothoracic surgery2025
Methylprednisolone and postoperative pulmonary function following minimally invasive cardiac surgery under ultra-fast-track anesthesia.
Article in Journal of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aimed to assess the association between intraoperative methylprednisolone administration and postoperative pulmonary function in patients undergoing minimally invasive cardiac surgery via a right axillary incision under ultra-fast-track anesthesia.
methodsClinical data from 238 patients who underwent minimally invasive cardiac surgery through a right axillary incision under ultra-fast-track anesthesia at Zhejiang Provincial People’s Hospital between January 2022 and July 2023 were retrospectively analyzed. Participants were assigned to either the methylprednisolone group (Group M, n = 119) or the control group (Group C, n = 119) according to whether methylprednisolone was administered after anesthesia induction. Pulmonary function was assessed using the oxygenation index (OI = PaO2/FiO2), respiratory index (RI = PA-aO2/PaO2), and incidence of pulmonary atelectasis and pulmonary edema. Measurements were obtained preoperatively (T0) and at 1 h (T1), 6 h (T2), 12 h (T3), and 24 h (T4) postoperatively.
resultsIn both groups, OI values from T1 to T4 were significantly lower than those at T0 but demonstrated a gradual postoperative increase. Group M exhibited higher OI values than Group C across all postoperative time points (T1–T4) (p < 0.05). RI values in both groups increased from T1 to T4 compared with T0 but presented a decreasing trend over time; RI values in Group M were significantly lower than those in Group C at all postoperative intervals (p < 0.05). At T2, hypersensitive C-reactive protein levels were significantly lower in Group M than in Group C (p < 0.05). No significant differences were observed between groups in the incidence of pulmonary atelectasis or pulmonary edema (p > 0.05).
conclusionIntraoperative administration of methylprednisolone at a dose of 1–4 mg/kg following induction of ultra-fast-track anesthesia for minimally invasive cardiac surgery via a right axillary incision was associated with improved gas exchange and oxygenation during the first 24 postoperative hours. These findings indicate a potential protective effect of methylprednisolone on pulmonary function in the early postoperative period following cardiopulmonary bypass.
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