HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Horneffer, P. J. Articles by Gardner, T. J. Search for Related Content PubMed PubMed Citation Articles by Horneffer, P. J. Articles by Gardner, T. J.

The Journal of Thoracic and Cardiovascular Surgery, Vol 100, 292-296, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

The effective treatment of postpericardiotomy syndrome after cardiac operations. A randomized placebo-controlled trial

PJ Horneffer, RH Miller, TA Pearson, MF Rykiel, BA Reitz and TJ Gardner
Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, MD 21205.

Although the postpericardiotomy syndrome is a common complication of cardiac operations, the most effective drug regimen for the treatment of this condition has not been established. The present study was designed to evaluate the effectiveness of nonsteroidal antiinflammatory drugs (NSAIDs) in the treatment of postpericardiotomy syndrome, in a double-blind, placebo-controlled randomized trial with a 10-day course of ibuprofen or indomethacin. Of 1019 adult patients undergoing cardiac operations during a 14-month period, a diagnosis of postpericardiotomy syndrome was made in 187, and 149 were enrolled in the study. Diagnosis was based on the presence of at least two of the following: fever, anterior chest pain, and friction rub. Drug efficacy was defined as the resolution of at least two of these criteria within 48 hours of drug initiation. Ibuprofen and indomethacin were 90.2% and 88.7% effective, respectively, and both were significantly more effective than placebo (62.5%, p = 0.003). The occurrence of side effects, including nausea, vomiting, renal failure, and fluid retention, was low in all groups (13.1% for ibuprofen, 16.1% for indomethacin, and 16.7% for placebo [p = not significant). Length of hospital stay, incidence of ischemic events, and accumulation of significant pericardial effusions were similar in all groups. The results of this study demonstrate that both ibuprofen and indomethacin provide safe and effective symptomatic treatment for postpericardiotomy syndrome.

This article has been cited by other articles:

				Task Force members, B. Maisch, P. M. Seferovic, A. D. Ristic, R. Erbel, R. Rienmuller, Y. Adler, W. Z. Tomkowski, G. Thiene, M. H. Yacoub, et al. Guidelines on the Diagnosis and Management of Pericardial Diseases Executive Summary: The Task Force on the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology Eur. Heart J., April 1, 2004; 25(7): 587 - 610. [Full Text] [PDF]

				C. Chen-Scarabelli Beating-Heart Coronary Artery Bypass Graft Surgery: Indications, Advantages, and Limitations Crit. Care Nurse, October 1, 2002; 22(5): 44 - 58. [Full Text] [PDF]

				A. R. Mott, C. D. Fraser Jr, A. V. Kusnoor, N. M. Giesecke, G. J. Reul Jr, K. L. Drescher, C. H. Watrin, E. O.B. Smith, and T. F. Feltes The effect of short-term prophylactic methylprednisolone on the incidence and severity of postpericardiotomy syndrome in children undergoing cardiac surgery with cardiopulmonary bypass J. Am. Coll. Cardiol., May 1, 2001; 37(6): 1700 - 1706. [Abstract] [Full Text] [PDF]