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[Comment] Steroids for cardiac surgery: has the story finally ended?

Cardiac surgery remains a key component of the treatment strategy for cardiovascular disease. The decision to offer surgery to a patient must include consideration of the potential benefits and likely harms. Much more work is needed to create a high-quality evidence base to minimise the harm associated with surgery, and hence maximise overall benefit.1 In the case of cardiac surgery, an important potential harm is the systemic inflammatory response to cardiopulmonary bypass.2 Therefore, a great deal of interest has arisen about how this harm might be mitigated, either by elimination of cardiopulmonary bypass altogether through off-pump cardiac surgery, or by modification of the inflammatory response through use of prophylactic corticosteroids.