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Canadian Journal of Anesthesia, Vol 25, 7-17, Copyright © 1978 by Canadian Anesthesiologists' Society

Effect of Corticosteroids on Endocrine Function in Haemorrhagic Shock

T. OYAMA 1, A. MATSUKI 1, T. KUDO 1, M. KUDO 1, M. YAMASHITA 1, and H. ISHIHARA 1

1 Department of Anesthesiology, Hirosaki University Medical School, Hirosaki, Aomori-ken, Japan

The effect of haemorrhage on endocrine function and the anti-shock effects of methylprednisolone were investigated in 32 mongrel dogs. Plasma concentrations of antidiuretic hormone (ADH), epinephrine, norepinephrine, aldosterone and cortisone were measured simultaneously during and following haemorrhagic hypotension. Other parameters, such as urine volume and osmolality, serum and urine electrolytes and blood glucose were also determined simultaneously during the procedure. Dogs anaesthetized with pentobarbitone were bled so that the mean arterial pressure decreased to 50 mm Hg, which was maintained for 15 minutes (group one) or for 30 minutes (groups two, three, and four). After the recovery of group one animals from the first hypotension by reinfusion of blood and hydroethylstarch, they were bled again to a mean arterial pressure of 50 mm Hg (second hypotension) and were allowed to remain at this pressure. In groups two, three and four there was no second hypotension.

Plasma ADH concentrations were elevated 50 times control values on the first hypotension, but no appreciable increase was observed on the second hypotension. Plasma levels of epinephrine, norepinephrine and aldosterone increased 35, 7, and 5 times respectively during the first hypotension and 40, 10, and 5 times during the second hypotension, as compared to controls. Plasma osmolality correlated well with plasma ADH levels during the haemorrhage. Increased concentrations of plasma ADH, epinephrine and norepinephrine following haemorrhage had a tendency to decrease after the administration of fluids, but they were still higher than the preshock control levels. Methylprednisolone 15 mg/kg or 30 mg/kg administered intravenously before infusion of blood and hydroethylstarch caused a significant decrease of plasma levels of ADH and epinephrine to pre-shock control levels. Our data suggest that the administration of methylprednisolone could be beneficial in improving the shock state from an endocrinological point of view.






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Copyright © 1978 by the Canadian Anesthesiologists' Society.