Marsetyawan Soesatyo
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The effect of combination of hemofilter, pre- and intraoperative methylprednisolone administration on systemic inflammatory response syndrome (SIRS) post open heart surgery Supomo, .; Aryandono, Teguh; Soesatyo, Marsetyawan; Sudiharto, Paulus
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (357.885 KB) | DOI: 10.19106/JMedSci004901201702

Abstract

Systemic inflammatory response syndrome (SIRS) occurs in almost all patients whom undergo open heart surgery causes the increase its morbidity and mortality. The effect of pre- and intraoperative methylprednisolone administration combined with hemofilter application in cardiopulmonary bypass machine in the reduction of SIRS incidence remains controversial. This study aimed to evaluate the effect pre- and intraoperative methylprednisolone administration combined with hemofilter on SIRS incidence after open heart surgery. This was an experimental study using prospective randomized open-blinded evaluation (PROBE) design. Ninety-five patients from Dr. Sardjito General Hospital, Yogyakarta, and Dr. Cipto Mangunkusumo General Hospital, Jakarta, who had open heart surgery within the period of December 2011 to May 2012 were enrolled in this study. The patients were randomly allocated into two groups i.e. Group A (48 patients) received pre-; intra-; and postoperative methylprednisolone (15; 5 and 5 mg/kg BW, respectively) and hemofilter and Group B (47 patients) just received intra- and postoperative methylprednisolone (15 and 5 mg/kg BW). The SIRS incidence was evaluated in 3; 24; 48 and 72 hours post surgery. This study showed that the SIRS incidence in Group B at 3 (OR= 0.12; 95%CI=0.03-0.39; p< 0.001) and 24 (OR= 0.38; 95%CI=0.14-0.996; p< 0.031) hours postoperative were significantly higher than that in Group A. In conclusion, pre- and intraoperative methylprednisolone administration combined hemofilter significantly decrease the SIRS incidence post open heart surgery.
The effect of hemofilter, preoperative and intraoperative methylprednisolone on complications after open heart surgery Supomo, .; Aryandono, Teguh; Soesatyo, Marsetyawan; Sudiharto, Paulus
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 4 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (431.059 KB) | DOI: 10.19106/JMedSci004904201704

Abstract

Complications after open heart surgery may threaten patient’s survival rate. Theintraoperative methylprednisolone administration alone shows controversial resultson open heart surgery complications. Similarly, the intraoperative and preoperativemethylprednisolone administration as well as the use of hemofilter in open heart surgeryis still controversial. This study aimed to evaluate the effect of hemofilter, preoperativeand intraoperative methylprednisolone administration on complications following openheart surgery. This was a Prospective Randomized Open-Blinded Evaluation (PROBE)experimental study. Ninety-five patients who had open heart surgery in Dr. SardjitoGeneral Hospital, Yogyakarta, and Integrated Cardiac Care of Dr. Cipto MangunkusumoGeneral Hospital, Jakarta within the period of December 2011 to May 2012 wereinvolved in this study. The patients were divided into two groups i.e. group A, 48 patientsreceived methylprednisolone 15mg/kg intraoperatively, methylprednisolone 5mg/kgpreoperatively, and hemofilter, while group B, 47 patients received methylprednisolone15mg/kg intraoperatively alone. From the total 95 patients, we found 26 (27.4%)patients experienced complications i.e. 19 in group B (40.4%) and 7 in group A(14.6%). The differences of the complications were statistically significant (p<0.05;OR=3.97; 95%CI=1.476-10.71). Complications risk decreased by 63.9% in the groupA compared to the group B with the hazard ratio of 3.2. In conclusion, the application ofhemofilter, preoperative and intraoperative methylprednisolone might decrease the risk ofcomplications after open heart surgery.