The Annals of Thoracic Surgery, Vol 22, 36-40, Copyright © 1976 by The Society of Thoracic Surgeons
Corticosteroids and prevention of pulmonary damage following cardiopulmonary bypass in puppies
DG Hill, MJ Aguilar, JC Kosek and JD Hill
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.
