Pulmonary response of massive steroids in seriously injured patients

Ann Surg. 1981 Sep;194(3):256-61. doi: 10.1097/00000658-198109000-00002.

Abstract

The effects of massive steroids on pulmonary function after hypovolemic shock were tested in 114 injured patients who received an average of 13 transfusions, 760 ml plasma, and 11.7 L crystalloid solution; by random selection, 54 patients received methylprednisolone (1 g in operating room plus 3,578 mg average during the next three days). The patients who received steroids had a significant increase in central venous pressure and a decrease in arterial oxygen tension (PaO2) compared with control patients. The inspired oxygen concentration was similar for both groups; the FiO2/PO2, therefore, was significantly deranged (P = less than 0.05) in steroid patients (0.45 +/- 0.05 SE vs 0.37 +/- 0.02 SE). The patients who received steroids has an insignificantly increased pulmonary shunt (25 vs 22%), number of days on a volume ventilator (5.1 vs 3.0 days), and number of deaths (seven vs two), Massive steroids neither prevent nor ameliorate pulmonary failure after shock; indeed, steroids may aggravate pulmonary failure after shock.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Transfusion
  • Central Venous Pressure / drug effects
  • Emergencies*
  • Humans
  • Lung / drug effects*
  • Lung / physiopathology
  • Methylprednisolone / administration & dosage*
  • Methylprednisolone / adverse effects
  • Oxygen / blood
  • Oxygen Inhalation Therapy
  • Respiratory Insufficiency / chemically induced
  • Respiratory Insufficiency / prevention & control
  • Resuscitation
  • Shock / therapy*
  • Wounds and Injuries / therapy*

Substances

  • Oxygen
  • Methylprednisolone