Low Dose Corticosteroid Infusion in Vasoplegia After Cardiac Surgery (CORTIVAS-CS)

Low Dose Corticosteroid Infusion in Vasoplegia After Cardiac Surgery (CORTIVAS-CS): a Prospective Randomized Double-blinded Clinical Trial

Vasoplegia is an important determinant for adverse postoperative outcome and is observerd in 5% to 54% of patients undergoing cardiac surgery using cardiopulmonary bypass (CPB).

Postoperative vasoplegia is defined as a state with low systemic vascular resistance despite a normal or high cardiac output, and the need for vasopressor therapy.

Steroids attenuate the inflammatory response to cardiopulmonary bypass,but their effect on clinical outcomes is uncertain.

This is a double-blinded, randomized, clinical trial designed to determine the efficacy of low dose corticosteroid infusion in vasopressor free-days in vasoplegia after cardiac surgery.

Inclusion Criteria:

• Cardiac surgery with cardiopulmonary bypass
• Norephinerine treatment in ICU with dose great or equal than 0,1 mcg/kg/min to maintain or restore a MAP over 70 mmHg for at least 30 minutes within 24 hours after surgery

Exclusion Criteria:

• Preoperative vasopressor use (within 72 hours prior to surgery)
• Preoperative steroids use (within 7 days prior to surgery)
• Presence of ventricular assist device other than intraaortic ballon pump
• Transplant procedures
• Emergency procedures
• Aortic repairs
• Congenital procedures
• Endocarditis
• Bacterial or fungal infection in the preceding 30 days
• Active neoplasia
• Pregnancy
• Recent history of gastrointestinal bleeding
• Allergy or intolerance to steroids
• Participation in other study