Pulmonary Response of Massive Steroids in Seriously Injured Patients

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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 3 days). The patients who received steroids had a significant increase in central venous pressure and a decrease in arterial O2 tension (Pa[arterial partial pressure]O2) compared with control patients. The inspired O2 concentration was similar for both groups; the FiO2[fractional concentration of inspired O2]/PaO2 was significantly deranged (P < 0.05) in steroid patients (0.45 .+-. 0.05 SE vs. 0.37 .+-. 0.02 SE). The patients who received steroids had 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 (7 vs. 2). Massive steroids did not prevent and ameliorate pulmonary failure after shock. Steroids may aggravate pulmonary failure after shock.