Comparative Study on the Effect of Prime Solution Included Dexamethasone Vs. Methyl Prednisone on Incidence of Postoperative Delirium in Patients with Open Heart Surgery by Cardio Pulmonary Bypass Circuit

Delirium is a fluctuating type of cognitive impairment and is common in hospitalized patients and after open heart surgery has been reported up to 90%, which leads to increased risk of dementia and hospitalization costs, reduced quality of life, risk of falls. Needs long-term care and etc. Activation of the deep inflammatory response dependent on the blood response and the cardiopulmonary pump circuit is one possible reason for this. Therefore, in this study, two anti-inflammatory drugs, dexamethasone and methylprednisolone, were used in Prime solution in cardiac surgery patients and then the occurrence of delirium was evaluated .

Methods and Materials:

 In this clinical trial study with a sample volume size 43 patients in open-heart surgery by on-pump method, after random assignment to two groups including dexamethasone and methylprednisolone that were added to prime solution. Inclusion criteria were EF more than 30%, candidate for mitral valve surgery, absence of cognitive impairment and preoperative delirium and age range 30-65 years. In the first group with 21 patients received dexamethasone at a dose of 0.1 mg/ kg and in the second group with 22 patients at a dose of 0.4 mg/Kg in prime solution. Then delirium examined with standard CAM-ICU instruments after extubation and then the results were analyzed with SPSS 21 version.

The results showed that only 18% of patients who received methylprednisolone primer solution and 28% of patients who received dexamethasone primer solution had delirium, and this difference was non-significant (P. value: 0.448).

In this study, the anti-inflammatory drug methylprednisolone were not superior to each other and had a similar effect on delirium