Methylprednisolone effect endothelial function during cardiac surgery under cardiopulmonary bypass

The aim of the study. Evaluate the effect of methylprednisolone on endothelial function in operations under normothermic cardiopulmonary bypass. 22 patients underwent operation without the use of methylprednisolone (control group) and 22 patients with intravenous methylprednisolone injection after induction of anesthesia in a dose of 20 mg/kg (study group). Microalbuminuria and the ratio of albumin to creatinine in urine were selected as markers of capillary leakage identified. Endothelin-1 and E-selectin were selected as markers of endothelial dysfunction. The levels of interleukin-6, interleukin-10, creatinine, albumin, cystatin C, blood glucose, blood gases and perioperative results were evaluated. In the methylprednisolone group the indicators of systemic inflammatory response were less at stages of study. However, there were an increase in markers of endothelial dysfunction and transient impairment of renal function and lung with no significant difference in markers of capillary leakage in this group by comparing with control group. The application of pulse-dose corticosteroids aggravates the effects of endothelial dysfunction (increased levels of endothelin-1 and E-selectin on the stages of the study) and negatively affects the recovery of pulmonary and renal function after cardiopulmonary bypass. The use of methylprednisolone does not reduce the manifestations of capillary leak syndrome.