Methylprednisolone and postoperative pulmonary function following minimally invasive cardiac surgery under ultra-fast-track anesthesia

Sep 30, 2026

Upload by awa

This retrospective study evaluated the relationship between intraoperative methylprednisolone administration and early postoperative pulmonary function in 238 patients undergoing minimally invasive cardiac surgery via a right axillary incision under ultra-fast-track anesthesia between Jan 2022 and Jul 2023. Patients received methylprednisolone after induction (Group M, n=119) or no methylprednisolone (Group C, n=119). Pulmonary outcomes were assessed using oxygenation index and respiratory index at multiple time points through 24 h. Group M showed higher oxygenation, lower respiratory index, and reduced hypersensitive C-reactive protein at T2 without differences in atelectasis or pulmonary edema.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Objective

Methods

Results

Conclusion

Introduction

Minimally invasive cardiac surgery and incision approach

Enhanced Recovery After Cardiac Surgery (ERACS)

Ultra-fast-track anesthesia (UFTCA) implementation

Importance of pulmonary function in UFTCA

Teng et al. Journal of Cardiothoracic Surgery (2026) 21:14 [https://doi.org/10.1186/s13019-025-03680-8](https://doi.org/10.1186/s13019-025-03680-8) Journal of Cardiothoracic Surgery RESEARCH Open Access Methylprednisolone and postoperative pulmonary function following minimally invasive cardiac surgery under ultra-fast-track anesthesia Haokang Teng1,2, Lixin Wang1, Shenjie Jiang3, Tian Jiang5, Linting Xu4, Meijuan Yan5,6*, Hanwei Wei5,6* and Xiaokan Lou5 Abstract Objective This study aimed to assess the association between intraoperative methylprednisolone administration and postoperative pulmonary function in patients undergoing minimally invasive cardiac surgery via a right axillary incision under ultra-fast-track anesthesia. Methods Clinical data from 238 patients who underwent minimally invasive cardiac surgery through a right axillary incision under ultra-fast-track anesthesia at Zhejiang Provincial People’s Hospital between January 2022 and July 2023 were retrospectively analyzed. Participants were assigned to either the methylprednisolone group (Group M, n = 119) or the control group (Group C, n = 119) according to whether methylprednisolone was administered after anesthesia induction. Pulmonary function was assessed using the oxygenation index (OI = PaO2/FiO2), respiratory index (RI = PA-aO2/PaO2), and incidence of pulmonary atelectasis and pulmonary edema. Measurements were obtained preoperatively (T0) and at 1 h (T1), 6 h (T2), 12 h (T3), and 24 h (T4) postoperatively. Results In both groups, OI values from T1 toT4 were significantly lower than those at T0 but demonstrated a gradual postoperative increase. Group M exhibited higher OI values than Group C across all postoperative time points (T1–T4)(p < 0. 05) . RI values in both groups increased from T1 toT4 compared with T0 but presented a decreasing trend overtime; RI values in Group M were significantly lower than those in Group C at all postoperative intervals (p < 0. 05) . At T2, hypersensitive C-reactive protein levels were significantly lower in Group M than in Group C (p < 0. 05) . No significant differences were observed between groups in the incidence of pulmonary atelectasis or pulmonary edema (p >0. 05) . Conclusion Intraoperative administration of methylprednisolone at a dose of 1–4 mg/kg following induction of ultra-fast-track anesthesia for minimally invasive cardiac surgery via a right axillary incision was associated with improved gas exchange and oxygenation during the first 24 postoperative hours. These findings indicate a *Correspondence: Meijuan Yan [yanmeijuanymj@126.com](yanmeijuanymj@126.com)[ ](yanmeijuanymj@126.com)Hanwei Wei [hanweiweiwhw@126.com](hanweiweiwhw@126.com) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/licenses/by-nc-nd/4.0/](vecommons.org/licenses/by-nc-nd/4.0/.)[.](vecommons.org/licenses/by-nc-nd/4.0/.) Teng et al. Journal of Cardiothoracic Surgery (202

FAQs

What was the study’s main objective?

To assess whether intraoperative methylprednisolone administration is associated with postoperative pulmonary function in patients undergoing minimally invasive cardiac surgery under ultra-fast-track anesthesia.

How were the two patient groups defined?

Participants were assigned to a methylprednisolone group (methylprednisolone given after anesthesia induction) or a control group based on whether methylprednisolone was administered.

What pulmonary function measures were used, and over what time frame?

Pulmonary function was evaluated using oxygenation index and respiratory index, along with incidence of pulmonary atelectasis and pulmonary edema, measured preoperatively and at 1, 6, 12, and 24 hours postoperatively.

Sep 30, 2026

Upload by awa