Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

AHA STEROID trial, dexamethasone in acute high-risk abdominal surgery, the protocol for a randomized controlled trial

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Continuous monitoring of vital sign abnormalities; association to clinical complications in 500 postoperative patients

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Diagnostic criteria of CNS infection in patients with external ventricular drainage after traumatic brain injury: a pilot study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Development of a core outcome set for general intensive care unit patients - a protocol

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Management of acute atrial fibrillation in the intensive care unit: An international survey

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Reasons for staying in hospital after video-assisted thoracoscopic surgery lobectomy

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Functional recovery after discharge in enhanced recovery video-assisted thoracoscopic lobectomy: a pilot prospective cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Pre-operative autonomic nervous system function - a missing link for post-induction hypotension?

    Research output: Contribution to journalEditorialResearchpeer-review

  • Mirjana Cihoric
  • Henrik Kehlet
  • Morten Laksáfoss Lauritsen
  • Jakob Højlund
  • Katrine Kanstrup
  • Nicolai Bang Foss
View graph of relations

INTRODUCTION: Existing multimodal pathways for patients undergoing acute high-risk abdominal surgery for intestinal obstruction (IO) and perforated viscus (PV) have focused on rescue in the immediate perioperative period. However, there is little focus on the peri-operative pathophysiology of recovery in this patient group, as done to develop enhanced recovery pathways in elective care. Acute inflammation is the main driver of the perioperative pathophysiology leading to adverse outcomes. Pre-operative high-dose of glucocorticoids provides a reduction in the inflammatory response after surgery, effective pain relief in several major surgical procedures, as well as reduce fatigue and improving endothelial dysfunction.

AIM: To evaluate the effect of high-dose glucocorticoid on the inflammatory response, fluid distribution and recovery after acute high-risk abdominal surgery in patients with IO and PV.

METHODS: AHA STEROID trial is a sponsor-initiated single-center, randomized, double-blind placebo-controlled trial, assessing preoperative high-dose dexamethasone (1 mg/kg) versus placebo (normal saline) in patients undergoing emergency high-risk abdominal surgery. We plan to enroll 120 patients. Primary outcome is the reduction in C-reactive protein on postoperative day 1 as a marker of successful attenuation of the acute stress response. Secondary outcomes include perioperative changes in endothelial and other inflammatory markers, fluid distribution, pulmonary function, pain, fatigue, and mobilization. The statistical plan is outlined in the protocol.

DISCUSSION: The AHA STEROID trial will provide important evidence to guide the potential use of high-dose glucocorticoids in emergency high-risk abdominal surgery, with respect to different pathophysiologies.

Original languageEnglish
Article number14040
JournalActa Anaesthesiologica Scandinavica
Volume66
Issue number5
Pages (from-to)640-650
Number of pages11
ISSN0001-5172
DOIs
Publication statusPublished - May 2022

Bibliographical note

This article is protected by copyright. All rights reserved.

ID: 74000448