Anti-inflammatory modalities: Their current use in pediatric cardiac surgery in the United Kingdom and Ireland

Objective: To determine the use of anti-inflammatory therapies in infants and children undergoing cardiac surgery in the United Kingdom and Ireland. Design: Questionnaire survey. Subjects: All centers that undertake pediatric cardiac surgery in the United Kingdom and Ireland. Results. All centers use at least one anti-inflammatory therapy, with 46% of centers using more than one. Both modified ultrafiltration (80%) and steroids (80%) are widely used as anti-inflammatory strategies. Among centers that use steroids, dose, preparation, and timing of steroid administered was. highly variable. Heparin-bonded circuits and aprotinin are infrequently used as anti-inflammatory techniques. Conclusion: Although anti-inflammatory interventions are believed to contribute to improved patient outcome following cardiopulmonary bypass, this survey has shown that there are still widespread variations in practice. Rather than reflecting poor clinical practice, we believe this reflects a lack of good evidence supporting clinical benefit. (Pediatr Crit Care Med 2009; 10: 341-345)