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Background Pericardial effusion is a known complication post cardiac surgery. 1 Management with prednisolone has been found to hasten the resolution of the effusion in the paediatric population.2 Prednisolone is not licensed for this indication and the dose is not defined. However, Mizumoto et al3 study discovered that 2mg/kg was effective in the treatment of post-surgical pericardial effusions. An evaluation of the prescribing practice of prednisolone for pericardial effusion was required to evaluate whether the current pharmacology treatment was effective in this centre.Method A retrospective evaluation of prednisolone dosing was undertaken. All patients prescribed prednisolone post cardiac surgery for pericardial effusion were identified, over a 12-month period, by utilising the electronic health record. The ECHO reports measuring the pericardial effusion pre and post the course of prednisolone were compared. In total thirteen patients were included, which represents 2.9% of the patients undergoing cardiac surgery during the sampling period.Results The duration of the doses varied from one day to five days, with the most common duration being three days. 56% of the prednisolone doses were 2mg/kg. 92% of patients had resolution of their effusion. No patients required drainage of their pericardial effusion or suffered haemodynamic compromise.Conclusion Prednisolone 2mg/kg for three days is the most prescribed course for pericardial effusion and has been shown to be effective in the management of pericardial effusion in this patient sample. If dosing is standardised at 2mg/kg for three days, it will allow the efficacy of the prednisolone course to be evaluated as a treatment approach in the future.References Noma M, Hirata Y, Hirahara N, Suzuki T, Miyata H, Hiramatsu Y, Yoshimura Y, Takamoto Y. Pericardial effusion after congenital heart surgery. JTHVS Open 2022 Jan 22;9:237–243. Available from: https://doi.org/10.1016/j.xjon.2022.01.001 Wilson NJ, Webber SA, Patterson MW, Sandor GG, Tipple M, LeBlanc J. Double-blind placebo-controlled trial of corticosteroids in children with post pericardiotomy syndrome. Pediatr Cardiol. 1994;15:62–65. Available from: https://doi.org/10.1007/bf00817608 Mizumoto M, Masaki N, Sai S. Efficacy of short-term oral prednisolone treatment in the management of pericardial effusion following pediatric cardiac surgery. Pediatr Cardiol. 2021 Dec 1;43(4):764–768. Available from: https://doi.org/10.1007/s00246-021-02783-y