Please select the eligibility criteria that correspond to the clinical trial below.
Title: Phase IV Study of Perioperative Steroid's Effects on Death or MI in High-Risk Patients Undergoing Cardiac Surgery Requiring Cardiopulmonary Bypass
Brief Summary: 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 Methylprednisolone or a matching placebo. Cardiopulmonary bypass initiates a systemic inflammatory response that facilitates development of post-operative complications. SIRS will confirm or deny the potential clinical benefits of suppressing this response through the use of systemic steroids. Specifically, does 250 mg of intravenous Methylprednisolone given twice, once on anesthetic induction and again on CPB initiation, result in improved early survival and less myocardial infarction in high-risk cardiac surgery patients requiring CPB?


Options:
A: Inclusion Criteria:

* Age over 18 years
* Cardiac Surgery elective of coronary artery bypass graft with cardiopulmonary bypass (CPB)
* The informed consent signature savvy

Exclusion Criteria:

* Use of steroids or anti-inflammatory drugs routine
* Presence of asthma, COPD, autoimmune diseases
* Participation in other clinical studies
* Presence of decompensated heart failures, liver or kidney
* Combined elective surgery (ex .: aneurysm correction + CABG)
* Acute myocardial infarction in the last 30 days
* Unstable angina
* And obesity (BMI\> 50kg / m2)
B: Inclusion Criteria:

* patients with infective endocarditis (according to DUKE criteria) undergoing cardiac surgery
* informed consent
* age ≥18 years

Exclusion Criteria:

* EuroScoreII ≤ 3
* current participation in another interventional Trial
* pregnancy
* current immunosuppressive or immunomodulatory therapy (with dosing of glucocorticoids over Cushing threshold)
* previous participation in the REMOVE study
C: 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
D: Inclusion Criteria:

* Patients at risks for acute tubular necrosis (patients with mechanical ventilation, patients with sepsis, in the post-operative state, with hemodynamic impairment or with previous chronic renal failure.
* Consent form signed

Exclusion Criteria:

* Patients with malignant hypertension
* Patients with systolic BP \> 150 mmHg at enrollment
* Patients with Hb level \> 120g/L
* Patients with acute coronaropathy
* Pregnancy
* Patients with urine output \< 600 ml/12 h

Answer: C