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Marvin M. Kirsh
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Ann Thorac Surg 1975;19:142-152
© 1975 The Society of Thoracic Surgeons


Articles

The Benefits of Corticosteroids in Endotoxic Shock

Richard Prager, M.D., Marvin M. Kirsh, M.D.*, Ernest Dunn, M.D., Ronald Nishiyama, M.D., John Straker, B.S., Robert Lee, B.S., Herbert Sloan, M.D.

From the Departments of Surgery and Pathology, The University of Michigan Medical Center, Ann Arbor, Mich.

Accepted for publication October 21, 1974.

* Address reprint requests to Dr. Kirsh, C-7175 University Hospital, Ann Arbor, Mich. 48104.

The experiments reported here were undertaken to study the effects of pharmacological doses of corticosteroids administered alone or in conjunction with prolonged (12-hour) assisted circulation in 22 dogs subjected to LD50–60 Escherichia coli endotoxin. The most striking findings were lengthened survival time, higher cardiac output, decreased fluid requirement, and minimal evidence of pulmonary congestion or injury in the animals treated with steroids only. Unexplained mesenteric infarction prematurely terminated the experiments in animals undergoing assisted circulation.

The benefits of corticosteroids in experimentally induced endotoxic shock are clearly demonstrated in these experiments. Further studies are needed to clarify the supportive role of assisted circulation in endotoxic shock and to determine any possible advantage of hypothermia over normothermia during its course.




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