Dexamethasone Does Not Help Children with Cardiac Surgery

A group of researchers have conducted a study that revealed that dexamethasone did not have the potential to limit the death rate among young infants that had undergone heart surgery. The study has been recently published in the Journal of the American Medical Association (JAMA).

As scientists around the world are in a race to develop the vaccine that can be used to beat the life-threatening coronavirus, no pharmaceutical drug has yet been introduced that can play a role against the deadly respiratory disease, COVID-19. However, the researchers are still looking for the answers and going through previous studies held on dexamethasone to check its effectiveness and reliability. Recently, it has been reported by the University of Oxford in a press release that dexamethasone can be used to reduce the mortality rate from COVID-19.

The researchers did a double-blind and multicenter randomized trial that involved 4 centers in China, Brazil, and Russia. The study held between December 2015 to October 2018 and completed the follow-ups in November 2018.

The data has consisted of 394 infants younger than 12 months that had gone through heart surgery with cardiopulmonary bypass (CPB). CPB refers to a technique that temporarily diverts the blood from the heart and lungs and provides pump function and oxygenation when the heart is still bloodless.

Source: Science Direct
Source: Liberal Dictionary

The team divided the study participants into two groups to compare the infants with one another to see if there is any reduction in the mortality rate and other complications. The first group had 194 kids that received the dose of dexamethasone 1 mg/kg for consecutive 30 days that began right after the cardiac surgery. The second placebo group had 200 kids that received equivolume of 0.9% sodium chloride intravenously after anesthesia induction.

Primary End Points: The main outcomes of the study that expected to occur between the 30 days after surgery were included a composite of death, and heart disease or cardiac event, need for extracorporeal membrane oxygenation (ECMO) which can be referred to as a support system for a person whose heart and lung are unable to pump blood circulation and gas exchange. Other outcomes involved acute kidney injury, prolonged mechanical ventilation, or neurological complications, and the need for cardiopulmonary resuscitation (CPR) which is an emergency medical procedure for a victim of cardiac or respiratory arrest and involves chest compression and breathing in airways.

Secondary End Points: There were a total of 17 secondary endpoints including the individual components of the primary endpoint, and duration of mechanical ventilation, inotropic index, intensive care unit stay, readmission to intensive care unit, and period of hospitalization.

By taking all into account, the investigators have found that primary endpoints were shown in 38.1% and 45.5% of the kids from the dexamethasone group and controlled group, respectively.  On another, there were no significant differences in secondary endpoints in both groups. The study also found the occurrence of infection in both groups. Of the total, 2% and 1.5% infection were seen in the first and second groups, respectively.

However, the current study suggests no significant complication of taking dexamethasone but still, there is a need for more research to find out clinical differences more accurately.

Meanwhile, the world is still fighting against the deadly coronavirus which has infected nearly 10.5 million people around the globe with more than 511,000 lives lost, according to data compiled by Johns Hopkins University (JHU).

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