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Prophylactic dexamethasone in pediatric open heart surgery PTX3 blood pentraxin elevations: Potential clinical significance

Prigione Ignazia

Administration of glucocorticoids before Cardio Pulmonary Bypass (PCB) may reduce the systemic inflammatory response and improve clinical outcomes. Pentraxin long PTX3 is a novel inflammatory parameter that may play a cardioprotective role by modulating inflammation. 29 children undergoing open heart surgery were enrolled in the study. Fourteen children received dexamethasone (first dose 1.5 mg/kg IV or IM one day before surgery; second dose 1.5 mg/kg IV before initiating bypass surgery) and fifteen children were used as controls. Blood PTX3, short C Reactive Protein (CRP), Interleukin-1 Receptor II (IL-1RII), fibrinogen, and Partial Thromboplastin Time (PTT) were measured at different time points. PTX3 levels were significantly increased during CPB in both Dexamethasone (+D) and Dexamethasone (-D)-treated and Non-Dexamethasone (-D)-treated subjects, but were significantly higher in +D than in -D patients. . CRP levels were significantly increased in both +D and -D patients in the postoperative days, with values significantly higher in -D patients than in +D patients. Fibrinogen and PTT values were significantly higher in -D patients than in +D patients on the first postoperative day.