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.