Impact of high-dose glucocorticoid on endothelial damage after liver resection - a double-blinded randomized substudy

Sandra E. L. T. Pitter*, Kristin J. Steinthorsdottir, Pär I. Johansson, Peter Nørgaard, Nicolai Schultz, Henrik Kehlet, Eske K. Aasvang

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstract

Objectives Postoperative endothelial damage potentially results in increased vascular leakage, tissue edema and subsequent complications. The preventive effect of glucocorticoids on endothelial damage after surgery is sparsely described, including the relation between endothelial damage and the postoperative inflammatory response. Thus, we aimed to assess the preventive effect of high-dose glucocorticoids on postoperative endothelial damage, and the association between endothelial damage and inflammation after surgery. Methods This was a predefined substudy of a randomized double-blinded clinical trial of methylprednisolone 10 mg/kg (high dose) vs. dexamethasone 8 mg (low dose) in patients undergoing liver resection at Rigshospitalet, Copenhagen. In total 25 patients undergoing major liver resection (11 in the high-dose group and 14 in the low-dose group) were included. The primary outcome was changed in five endothelial biomarkers and the secondary outcome was changes in inflammation [C-reactive protein (CRP)] for the first three postoperative days. Results No statistically significant difference was found for any endothelial biomarkers postoperatively between the two groups (P > 0.15, for all). High-dose glucocorticoids significantly reduced CRP on day 3 compared to low-dose glucocorticoids [median difference on a postoperative day 3, 59.6 g/L, (84.2; 27.1), P < 0.002]. No significant correlation between endothelial damage and CRP levels was seen. Conclusions No significant effect of high- vs. low-dose glucocorticoids on development in endothelial biomarkers after major liver resection was observed. High-dose glucocorticoids reduce the inflammatory response though without correlation to endothelial damage. Future studies should assess the clinical impact of increased endothelial biomarkers for clinical perioperative outcomes.

OriginalsprogEngelsk
TidsskriftEuropean journal of gastroenterology & hepatology
Vol/bind34
Udgave nummer11
Sider (fra-til)1178-1186
Antal sider9
ISSN0954-691X
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
The study was funded by the participating institutions.

Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.

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