Open AccessPulmonary Response of Massive Steroids in Seriously Injured Patients
Author(s) -
Charles E. Lucas,
Anna M. Ledgerwood
Publication year - 1981
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198109000-00002
Subject(s) - medicine , shock (circulatory) , oxygen tension , methylprednisolone , arterial oxygen tension , anesthesia , pulmonary function testing , oxygen , lung , chemistry , organic chemistry
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.