Effects of Dexamethason on the Early Postoperative Course after Coronary Artery Bypass Surgery

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Abstract
The effects of dexamethason (DM) on the postoperative course of coronary artery bypass have been investigated in a double blind study. Twenty patients receiving dexamethason 1 mg/kg body weight intravenously (IV) before cardiopulmonary bypass are compared with a control group of 20 patients receiving placebo. In the treated group core temperature remained normal (maximum 37.6 ± 0.5 °C) while in the control group the patients regularly developed fever (39.0 ± 0.7 °C; p < 0.01). In the DM-treated group a significantly higher blood pressure, and a lower incidence of rhythm disorders were found. There was a marked difference in the fluid requirements between the 2 groups. Without DM the fluid balance was 2,300 cc positive at the end of the study, in the treatment group this excess was only 1,000 cc (p < 0.001). Dexamethason treatment also led to higher urine output (130 cc/hr, vs. 85 cc/hr). Although the arterial oxygen tension was higher in the treated group, no patient developed respiratory insufficiency in the control group. The post-pump syndrome is re-evaluated and possible mechanisms are discussed.

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