Steroids In caRdiac Surgery Trial (SIRS Trial)Cardiopulmonary steroids in cardiac surgery trial CPB is a commonly performed surgical procedure with overper year in North America. CPB initiates a systemic inflammatory response characterized by both cell and protein activation. Trenton times, neutrophils, monocytes, macrophages, coagulation, fibrinolytic, and kallikrein cascades all take part in what results in increased endothelial permeability, vascular, and parenchymal damage. These inflammatory pathways facilitate development of post-operative complications including thrombosis, myocardial injury and infarction, respiratory failure, renal and neurological dysfunction, bleeding disorders, altered liver function and ultimately, multiple organ failure. In an attempt to minimize the deleterious effects of CPB, investigators have tested a variety of strategies in cardiac surgery ranging from the complete avoidance of CPB, to the use of biocompatible circuits and steroids in cardiac surgery trial agents to abrogate the systemic response. Investigators have consistently demonstrated the efficacy of steroids as the most potent anti-inflammatory agent for use during CPB. In fact, from the available evidence, the AHA guidelines for coronary artery bypass grafting CABG "support liberal prophylactic use in patients undergoing extracorporeal circulation".
Rationale and design of the Steroids in Cardiac Surgery trial - ScienceDirect
Steroids In caRdiac Surgery trial SIRS is a large international randomised controlled trial of methylprednisolone or placebo in patients undergoing cardiac surgery with the use of a cardiopulmonary bypass pump. At the time of surgery, compared with placebo, methylprednisolone divided into two intravenous doses of mg each may reduce the risk of postoperative acute kidney injury AKI.
With respect to the study schedule, over substudy eligible patients from 81 centres in 18 countries were randomised in December The stage of AKI will also be considered, as will the outcome of AKI in those with and without preoperative chronic kidney disease. After receipt of grant funding, the authors began to record additional perioperative serum creatinine measurements in consecutive patients enrolled at substudy participating centres, and patients were invited to enroll in a 6-month serum creatinine collection.
In these trial subpopulations, the authors will consider the outcome of AKI defined in alternate ways, and the outcome of a 6-month change in kidney function from the preoperative value. Ethics approval was obtained for additional serum creatinine recordings in consecutive patients enrolled at participating centres.
The additional kidney data collection first began for patients enrolled after 1 March In patients who provided consent, the last 6-month kidney outcome data will be collected in The results will be reported no later than National Center for Biotechnology Information , U. Didn't get the message? Add to My Bibliography.
Generate a file for use with external citation management software. Author information 1 Western University, London, Canada. Images from this publication. See all images 1 Free text. Inflammation in cardiac surgery with a cardiopulmonary bypass pump, and mechanism by which acute kidney injury may be prevented by perioperative corticosteroids.