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Steroid Therapy Attenuates Acute Phase Reactant Response Among Children on Ventricular Assist Device Support  Jonathan W. Byrnes, MD, Adnan T. Bhutta,

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Presentation on theme: "Steroid Therapy Attenuates Acute Phase Reactant Response Among Children on Ventricular Assist Device Support  Jonathan W. Byrnes, MD, Adnan T. Bhutta,"— Presentation transcript:

1 Steroid Therapy Attenuates Acute Phase Reactant Response Among Children on Ventricular Assist Device Support  Jonathan W. Byrnes, MD, Adnan T. Bhutta, MD, Mallikarjuna Rao Rettiganti, PhD, Alberto Gomez, BA, Xiomara Garcia, MD, Umesh Dyamenahalli, MD, MRCP(UK), Charles Johnson, CPP, Robert D.B. Jaquiss, MD, Michiaki Imamura, MD, PhD, Parthak Prodhan, MD  The Annals of Thoracic Surgery  Volume 99, Issue 4, Pages (April 2015) DOI: /j.athoracsur Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) Summary of number of steroid courses and indications for steroids over the study period. (B) Proportion of patients on ventricular assist device (VAD) and those receiving corticosteroids for systemic inflammatory response syndrome as the clinical indication. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) Initial therapy with steroids for systemic inflammatory response syndrome (SIRS) as a function of what day steroids were started. (B) Total episodes of steroid therapy for SIRS as a function of what day steroids were started (to reflect the multiple courses in some patients received during their ventricular assist device courses). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A) Distribution of serum fibrinogen levels for 21 events from baseline to day 5 of corticosteroid use for systemic inflammatory response syndrome (SIRS). The estimated means along with 95% confidence intervals (CI) from the repeated measures model are also shown. (B) Distribution of C-reactive protein levels for 21 events from baseline to day 5 of corticosteroid use for SIRS. The estimated means along with 95% confidence intervals from the repeated measures model are also shown. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Typical patient with recurrent systemic inflammatory response syndrome (SIRS) with depiction of C-reactive protein (CRP) and fibrinogen levels while on ventricular assist device support. Dotted line represents fibrinogen levels in milligrams/deciliter (mg/dL) with the axis on the left. Dashed line represents CRP levels in milligrams/deciliter with the axis on the right. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Response of C-reactive protein (CRP) and corticosteroids when started in the immediate postoperative period. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions


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