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Ann Thorac Surg 1978;25:536-540
© 1978 The Society of Thoracic Surgeons

Articles

Preservation of Myocardial Contractility in Hemorrhagic Shock with Methylprednisolone

G. Merin, M.D.*, D. Eimerl, M.D., S. Raz, B.Sc., D. Tzivoni, M.D., M.S. Gotsman, M.D.

Departments of Cardiothoracic Surgery, Anesthesiology, and Cardiology, Hadassah University Hospital and Hebrew University–Hadassah Medical School, Jerusalem, Israel

Accepted for publication November 17, 1977.

* Address reprint requests to Dr. Merin, Department of Cardiothoracic Surgery, Hadassah University Hospital, PO Box 499, Jerusalem, Israel

The left anterior descending or left circumflex coronary artery was cannulated selectively in 10 dogs. Methylprednisolone, 1 mg per kilogram of body weight, was injected into the artery and the cannula was withdrawn. The animals were then subjected to hemorrhagic shock for 90 minutes. Retransfusion to prestudy blood pressure was then accomplished. The electrocardiogram, arterial blood pressure, contractile force, and first derivative of contractile force were recorded continuously both from the areas that were pretreated and those that were not, the controls. Contractile force in the control area was reduced to 32 ± 3.2% of the preshock period after 90 minutes of shock, whereas in the pretreated area it was twice as high at the same time. Ten minutes after transfusion, the contractile force of the pretreated area exceeded the preshock level, whereas the recovery of contractile force in the control area reached only 70% of the preshock level. This study shows that intracoronary infusion of methylprednisolone can afford myocardial protection in hemorrhagic shock to a significant degree.






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