 In retrospect, the primary endpoints of both DECS and SIRS trials can be challenged, in that they used composites heavily weighted by thrombotic events MI, stroke and not specific to inflammation respiratory failure, kidney injury, sepsis, prolonged ICU and hospital stay, mortality. We thus plan to re-evaluate dexamethasone in cardiac surgery, using a patient-centred, clinically important endpoint focused on enhanced recovery and earlier hospital discharge: days alive and at home up to 30 days after surgery. 