چکیده (انگلیسی):

A best evidence topic was written according to a structured protocol. The question addressed was: Is the
use of prophylactic, perioperative steroids associated with better clinical outcomes following heart
surgery in neonates? Altogether, 194 papers were found using the reported search, of which 8 represented
the best evidence to answer the clinical question. One study found improved hospital survival in
the group without steroids. Steroids increased infection in one large retrospective study. Incidence of
hyperglycaemia was increased in the steroid group in 2 out of 5 studies. Use of steroids was associated
with a shorter duration of ventilation and better oxygenation in one study. Postoperative steroid infusion
was associated with reduced low cardiac output syndrome, inotrope requirement and less fluid retention
in two controlled trials in which all patients received preoperative steroid. High dose steroid was
associated with renal dysfunction in one study, comparing single versus double dose steroid prophylaxis.
Steroid non-recipients had a shorter intensive care length of stay in 2 out of 7 studies. We conclude that
use of steroids perioperatively does not unequivocally improve clinical outcome in neonatal heart surgery.
A large, multicentre prospective randomized controlled trial is needed to clarify the role of steroids
in paediatric heart surgery.