Cardiothoracic Anesthesia and Critical Care: An Ever-Changing (and Evolving) Field

Cardiac surgery and cardiopulmonary bypass are associated with an intense activation of the immune system. The systemic inflammatory response that develops in many cardiac surgical patients has the potential to lead to significant postoperative morbidity, and even mortality. Intraoperative corticosteroids are often used as prophylaxis for this systemic inflammatory response. This update provides a review of the existing evidence of the effects of corticosteroids on clinical outcomes after cardiopulmonary bypass, and combines this with emerging evidence from a recently published first large clinical trial of dexamethasone in cardiac surgery.