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Prophylactic and Delayed Treatment with High‐Dose Methylprednisolone in a Porcine Model of Early ARDS Induced by Endotoxaemia
Author(s) -
Borg T.,
Gerdin B.,
Modig J.
Publication year - 1985
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1985.tb02307.x
Subject(s) - methylprednisolone , medicine , ards , pulmonary hypertension , anesthesia , respiratory distress , sepsis , lung , gastroenterology
The effects of prophylactic and delayed treatment with high‐dose methylprednisolone were evaluated in a porcine model of early adult respiratory distress syndrome induced by endotoxaemia. Spontaneously breathing pigs under ketamine anaesthesia were infused i. v. with E. coli endotoxin (10 μg · h ‐1 · kg ‐1 ) over 6 h. Twenty animals received endotoxin without treatment. Eight animals were pretreated with methylprednisolone i. v., 60 mg · kg ‐1 , followed by an i. v. infusion at a rate of 10 mg · h ‐1 kg ‐1 . Ten animals received the same dosage of methylprednisolone beginning 2 h after the start of endotoxin infusion. Pretreatment with methylprednisolone prevented the endotoxin‐induced impairment in pulmonary gas exchange and the development of pulmonary oedema. The pulmonary hypertension was counteracted. Cardiac output (Q 1 ) and O 2 delivery were improved. Mean arterial blood pressure (MAP) increased and was higher than in the untreated endotoxin group. The profound fall in PMN count was inhibited, while the accumulation of these cells in the lung was still substantial. Survival was improved. Delayed methylprednisolone treatment prevented further deterioration in pulmonary gas exchange and tended to restore it towards baseline. The pulmonary oedema and pulmonary hypertension were reduced. Q 3 and O 2 delivery did not improve. MAP was higher than in the untreated endotoxin group towards the end of the observation period. The decline in PMN count and the pulmonary accumulation of these cells were not significantly influenced. Survival was improved. These results indicate that high‐dose methylprednisolone, when given early in the course of sepsis, might be of clinical value in prevention of the devastating pulmonary and circulatory complications of this disease.