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Ann Thorac Surg 1976;22:36-40
© 1976 The Society of Thoracic Surgeons

Articles

Corticosteroids and Prevention of Pulmonary Damage Following Cardiopulmonary Bypass in Puppies

David G. Hill, M.D., Mary Jane Aguilar, M.D.*, Jon C. Kosek, M.D., J. Donald Hill, M.D.

Heart Research Institute, Institutes of Medical Sciences, the Department of Pathology, and Presbyterian Hospital, Pacific Medical Center, San Francisco, and Stanford University Medical Center, Palo Alto, CA

Accepted for publication November 6, 1975.

* Address reprint requests to Dr. Aguilar, Department of Pathology, Pacific Medical Center, PO Box 7999, San Francisco, CA 94120

A technique of inducing hypothermia using surface cooling and rewarming with a pump oxygenator has been applied clinically in infants with satisfactory results. Respiratory problems postoperatively, however, are reported to be among the complications contributing most to mortality and morbidity. Prednisolone sodium succinate (Solumedrol) has helped to obviate pulmonary damage in hemorrhagic and endotoxic shock and therefore may be effective in preventing pulmonary damage following hypothermia. This hypothesis was investigated in 12 mongrel puppies, 6 that had hypothermic cardiopulmonary bypass and circulatory arrest but were not given Solumedrol, and 6 that were treated preoperatively with Solumedrol. In lung biopsies taken immediately after bypass the pathological changes in both the group treated with steroids and the control group were similar. At six hours, however, lung biopsies from the control group showed further signs of progressive damage, while in the steroid-treated group there was a striking improvement with some lung biopsies showing a normal appearance. Thus, Solumedrol did not prevent initial lung damage, but the progressive and probably permanent changes were reduced.






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Copyright © 1976 by The Society of Thoracic Surgeons.