Effects of dexamethasone on early cognitive decline after cardiac surgery

医学 地塞米松 入射(几何) 安慰剂 麻醉 置信区间 术后认知功能障碍 心脏外科 随机对照试验 内科学 外科 认知 精神科 光学 物理 病理 替代医学
作者
Sandro Glumac,Goran Kardum,Lidija Šodić,Daniela Šupe‐Domić,Nenad Karanović
出处
期刊:European Journal of Anaesthesiology [Lippincott Williams & Wilkins]
卷期号:34 (11): 776-784 被引量:74
标识
DOI:10.1097/eja.0000000000000647
摘要

BACKGROUND Postoperative cognitive decline (POCD), a very common complication after cardiac surgery, is characterised by impairment of both memory function and intellectual ability as well as being associated with increased use of healthcare resources. The investigators focused on the role of the inflammatory response to a surgical procedure as a potential factor involved in the pathogenesis of POCD. OBJECTIVE The use of prophylactic dexamethasone to attenuate the inflammatory response was hypothesised to reduce the risk of POCD. DESIGN Randomised controlled study. SETTING Single university teaching hospital, from March 2015 to January 2016. PATIENTS A total of 169 patients scheduled for elective cardiac surgery were enrolled, and 161 patients were included in the analyses. INTERVENTION Patients were randomised to receive a single intravenous bolus of 0.1 mg kg−1 dexamethasone (n = 85) or placebo (n = 84) 10 h before the surgery. MAIN OUTCOME MEASURES The primary outcome measure in both groups was the incidence of POCD on the 6th day after surgery. The investigators also evaluated the effect of dexamethasone on the incidence of systemic inflammatory response syndrome, postoperative C-reactive protein levels and postoperative serum S100β protein levels. RESULTS Compared to the placebo group, the dexamethasone group showed statistically significant reductions in the incidence of POCD (relative risk, 0.43; 95% confidence interval, 0.21 to 0.89; P = 0.02), the incidence of systemic inflammatory response syndrome (30.0 versus 58.0%, P < 0.001) and postoperative C-reactive protein levels (P < 0.001). Postoperative S100β levels were insignificantly lower (P = 0.56) in the dexamethasone group. CONCLUSION Preoperative administration of dexamethasone reduced the inflammatory response and thereby decreased the risk of early POCD after cardiac surgery. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT02767713.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
jjjdcjcj发布了新的文献求助10
刚刚
周破儿完成签到,获得积分10
刚刚
量子星尘发布了新的文献求助10
刚刚
传奇3应助明朗采纳,获得10
1秒前
1秒前
1秒前
2秒前
senhoo发布了新的文献求助10
2秒前
2秒前
小狗完成签到 ,获得积分10
3秒前
4秒前
4秒前
昏睡的实验室小白完成签到,获得积分10
5秒前
5秒前
yar应助大青山采纳,获得10
5秒前
Rondab应助mariawang采纳,获得10
5秒前
yqb发布了新的文献求助10
5秒前
5秒前
一条裸游的鱼完成签到,获得积分10
7秒前
二白关注了科研通微信公众号
7秒前
8秒前
8秒前
超帅听枫发布了新的文献求助10
8秒前
10秒前
10秒前
fish1116发布了新的文献求助100
10秒前
10秒前
bbbbb沫完成签到,获得积分20
10秒前
峥2发布了新的文献求助10
10秒前
wzy完成签到,获得积分10
10秒前
xxxllllll发布了新的文献求助10
11秒前
干净映天完成签到 ,获得积分10
11秒前
LJ_scholar发布了新的文献求助10
12秒前
kuny完成签到,获得积分10
12秒前
勤恳的夏之完成签到,获得积分20
13秒前
wzy发布了新的文献求助10
13秒前
钵钵鸡完成签到 ,获得积分10
13秒前
JING发布了新的文献求助10
13秒前
後zgw完成签到,获得积分10
15秒前
15秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3988732
求助须知:如何正确求助?哪些是违规求助? 3531027
关于积分的说明 11252281
捐赠科研通 3269732
什么是DOI,文献DOI怎么找? 1804764
邀请新用户注册赠送积分活动 881869
科研通“疑难数据库(出版商)”最低求助积分说明 809021