DECS-II
Trial question
What is the role of high-dose dexamethasone in patients undergoing cardiac surgery?
Study design
Multi-center
Single blinded
RCT
Population
Characteristics of study participants
20.0% female
80.0% male
N = 1865
1865 patients (382 female, 1483 male).
Inclusion criteria: patients undergoing cardiac surgery.
Key exclusion criteria: poor language comprehension; T1DM; endocarditis or other evidence of sepsis; preoperative corticosteroids.
Interventions
N=737 dexamethasone (at a dose of 1 mg/kg, maximum dose of 100 mg).
N=1128 standard care (no dexamethasone with standard care).
Primary outcome
Median number of home days
23 days
23.1 days
23.1 days
17.3 days
11.6 days
5.8 days
0.0 days
Dexamethasone
Standard
care
No significant
difference ↔
No significant difference in median number of home days (23 days vs. 23.1 days; MD 0.1, 95% CI -0.3 to 0.5).
Secondary outcomes
Significant decrease in median ICU stay (29 hours vs. 43 hours; MD -14, 95% CI -23.52 to -4.48).
Conclusion
In patients undergoing cardiac surgery, dexamethasone was not superior to standard care with respect to median number of home days.
Reference
Paul S Myles, Jan M Dieleman, Karin E Munting et al. Dexamethasone for Cardiac Surgery: A Practice Preference-Randomized Consent Comparative Effectiveness Trial. Anesthesiology. 2024 Nov 1;141(5):859-869.
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