Grant: Operating Grant

SIRS trial is a large simple study in which high-risk patients undergoing cardiac surgery requiring the use of cardiopulmonary bypass (CPB) are randomly allocated to receive a pulse dose of steroids or a matching placebo. Cardiopulmonary bypass initiates a systemic inflammatory response that contributes to post-operative complications. A review of the available literature demonstrates that there is evidence that steroids decrease this unfavorable response and may have clinical benefit while having an excellent safety profile. In fact, from the available evidence, the 2004 AHA guidelines for coronary artery bypass grafting (CABG) support liberal prophylactic use in patients undergoing extracorporeal circulation. However, cardiac surgeons are resistant to adopt this practice for fears of adverse effects of peri-operative steroids and because the available studies are too small to make conclusive statements. This study of 7500 patients will address whether pulse dose steroids result in improved early survival and less heart injury in cardiac surgery requiring CPB. This inexpensive and accessible treatment has the potential to save many lives.