Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effect of Postoperative Hydrocortisone on Cardiovascular and Respiratory Function in Neonates Undergoing Cardiopulmonary Bypass
Brief Summary: This protocol is designed to offer insight into critical illness related corticosteroid insufficiency and steroid supplementation in neonates undergoing cardiac surgery with cardiopulmonary bypass by administering exogenous steroids in the immediate post-operative period.


Options:
A: Inclusion Criteria:

1. Age greater than 18 years
2. Require CPB for any cardiac surgical procedure (such as CABG, Valve, Aorta, or combined procedures)
3. Must have a EuroSCORE ≥ 6
4. Provide written informed consent

NOTE: For participating sites in India, China and Hong Kong, the following eligibility criteria will be applied:

1. Age greater than 18 years
2. Require CPB for any cardiac surgical procedure (such as CABG, Valve, Aorta, or combined procedures)
3. Must have at least one of the following:

   1. EuroSCORE greater than or equal to 4 and undergoing valvular surgery
   2. EuroSCORE greater than or equal to 6 and undergoing any other cardiac surgery procedure (i.e. CABG, Aorta)
4. Provide written informed consent

Exclusion Criteria:

1. Use of systemic corticosteroids
2. History of bacterial or fungal infection in last 30 days
3. Allergy/intolerance to corticosteroids
4. Will receive Aprotinin
5. Previous participation in study
B: Inclusion Criteria:

* Age \< 1 year at the time of surgery
* Undergoing heart surgery with CPB as part of standard clinical care
* Availability and willingness of the parent/legally authorized representative to provide written informed consent

Exclusion Criteria:

* \< 37 weeks adjusted gestational age at time of surgery
* Any oral or intravenous steroid treatment within two days of surgery
* Any patient receiving any of the following medications within 2 days of surgery:

Amphotericin B, aminoglutethimide, anticholinesterases, warfarin, P450 3A4 inducers including (but not limited to) carbamazepine, phenobarbital, phenytoin, rifampin, bosentan and nafcillin or P450 3A4 inhibitors including (but not limited to) clarithromycin, voriconazole, itraconazole, ketoconazole, ciprofloxacin, diltiazem, fluconazole, erythromycin and verapamil.

* Infection contraindicating steroid use
* Preoperative mechanical circulatory support or active resuscitation at the time of randomization
* Emergent surgery precluding steroid administration 8-12 hours before surgery
C: Inclusion Criteria:

1. Neonate (\< 28 days old) undergoing correct cardiac surgery, or infants undergoing the following surgery procedures: Norwood, Arterial Switch, Total Anomalous Pulmonary Venous Return Repair, Interrupted Aortic Arch Repair, Truncus Arteriosus Repair
2. Successfully weaned off cardiopulmonary bypass after cardiac surgery

Exclusion Criteria:

1. requirement for extracorporeal membrane oxygenation (ECMO) in the operating room
2. Known immune deficiency
3. Having previously received systemic steroids (except for two routine preoperative doses)
4. A current signed Do not resuscitate (DNR) or limitation of care order
5. Current enrollment in another interventional clinical study
6. Refusal of parental consent
7. Previous diagnosis of adrenal insufficiency
8. \> 28 days old at time of surgery whose repair dose not require CPB
D: Inclusion Criteria:

* Participants undergoing cardiac surgery: coronary artery bypass grafting, heart valve surgery or a combined procedure,
* Procedure must be elective

Exclusion Criteria:

* Symptomatic cerebrovascular disease,
* Cerebrovascular incident in last 3 years,
* Neurodegenerative disease,
* Psychiatric disease,
* Visual, hearing or motor impairment interfering with cognitive testing,
* Carotid artery stenosis ( ≥50%),
* Myocardial infarction within last 3 months,
* Left ventricular ejection fraction of ≤35%,
* Previous cardiac or carotid surgery,
* Uncontrolled systemic hypertension (blood pressure≥180/110 mmHg),
* Corticosteroid-dependent asthma,
* Chronic obstructive pulmonary disease (COPD),
* Malignancy, liver disease (aspartate transaminase (AST), alanine transaminase (ALT) or bilirubin ˃1.5x above reference range),
* Kidney disease (serum creatinine ˃1.7 mg/dl or blood urea nitrogen ˃50 mg/dL),
* Uncontrolled diabetes mellitus (postprandial glucose ˃200 mg/dL or hemoglobin A1c ˃9%),
* Endocrine and metabolic diseases, requiring steroid treatment longer than 7 days in the past year,
* Alcohol or controlled substance abuse,
* Individuals without primary school education,
* Preoperative C reactive protein ˃0.5 mg/dL,
* Preoperative white blood cell count \<3 x109/L or ˃11 x109/L,
* Preoperative Mini mental score \<26 points,
* Preoperative Beck's depression inventory score ˃ 19 points,
* Intraoperative plan change (conversion from "off-pump" to "on-pump" and vice versa),
* Need for deep hypothermic circulatory arrest,
* Additional corticosteroid treatment throughout the study period.

Answer: C