Steroid Utilization for Pediatric Ventricular Assist Device-Associated Inflammation and Association With Outcomes
Retrospective cohort published in ASAIO Journal (2025)
Abstract
The impact of methylprednisolone (MP) on ventricular assist device (VAD)-associated inflammation in children and its association with outcomes remains unclear. We report this single-center retrospective study of children less than 21 years old supported with a VAD from February 2018 to December 2022. Methylprednisolone utilization, serial laboratory markers of hemolysis, inflammation, anticoagulation, and VAD adverse outcomes were analyzed. Sixty-eight patients (47% male, median age 3.2 years, 54% pulsatile flow) were included. Thirty-three patients (49%) received MP during VAD support, starting at a median 9 days post-implant (interquartile range [IQR]: 7-14), and for a median of 4 days (IQR: 3-5). Post-MP, there was a significant reduction in c-reactive protein (CRP) (12.4-3.2 mg/dl, p < 0.001) and fibrinogen (592-325 mg/dl, p < 0.001). Patients receiving MP had a higher daily rate of decline of fibrinogen ( p = 0.024) and higher bivalirudin dose ( p = 0.013) in the 2nd week post-implant. Methylprednisolone utilization was associated with higher proportion of stroke ( p = 0.023), infection ( p = 0.010), and pump thrombosis ( p = 0.023). Methylprednisolone is used frequently during pediatric VAD support and reduces inflammatory markers. Infectious and thrombotic complications were more common in the cohort receiving MP, and larger studies are needed to investigate this further.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Sixty-eight pediatric VAD patients on bivalirudin showed that methylprednisolone administration reduced CRP and fibrinogen but was associated with higher rates of stroke, infection, and pump thrombosis, plus elevated bivalirudin dose requirements.
Warum dies für die Hirudotherapie relevant ist
This single-center retrospective study of 68 pediatric ventricular assist device (VAD) patients examined methylprednisolone (MP) utilization for device-associated inflammation, finding that MP (used in 49% of patients) significantly reduced CRP and fibrinogen but was associated with higher proportions of stroke, infection, and pump thrombosis. Patients receiving MP also had higher bivalirudin doses in the second week post-implant. The abstract mentions bivalirudin only as an anticoagulant with higher dosing in MP recipients and provides no pharmacological detail about it; there is no mention of hirudin, leech saliva, leech therapy, or the leech secretome. The study centers on corticosteroid use for inflammation, not on anticoagulation, and no defensible relevance to ASH's domain can be drawn from the abstract.
Zitation
Steroid Utilization for Pediatric Ventricular Assist Device-Associated Inflammation and Association With Outcomes.
Ankola AA et al. · ASAIO Journal, 2025
Verwandter klinischer Kontext
Erfahren Sie, wie diese Forschung mit der klinischen Praxis verknüpft ist
Zur ASH-Bibliothek hinzugefügt: May 27, 2026 · Letzte Aktualisierung der Website: June 18, 2026