Effects of Steroid Pretreatment on Development of Shock Lung: Hemodynamic, Respiratory and Morphologic Studies

摘要

The pathogenesis of the pulmonary injury in shock is obscure. Recent studies have emphasized pulmonary vascular changes, including the presence of dilated pulmonary capillaries filled with leukocytes which degranulate and disintegrate. This study explores the possibility that release of leukocyte lysosomes in the pulmonary capillaries might cause endothelial damage, and that these effects could be obviated by the stabilization of leukocyte lysosomes with steroids or salicylates. Rhesus monkeys subjected to endotoxin shock were pretreated with low dose corticosteroids (cortisone acetate 15 mg/kg), high dose corticosteroids (methylprednisolone 30 mg/kg) or salicylates (sodium salicylate 100-400 mg/kg), and compared with a non-pretreated control group in endotoxin shock. Twelve monkeys subjected to hemorrhagic shock were studied with or without pretreatment with 30 mg/kg of methylprednisolone. Pretreatment of endotoxin shock with steroids or salicylates or hemorrhagic shock with steriods, did not significantly improve the hemodynamic effects of shock. Furthermore, the anti-inflammatory substances did not prevent leukocyte sequestration in the pulmonary capillaries, or other histologic abnormalities characteristically seen in the lungs in the early phase of shock. (Author)