title: Neuroendocrine and cardiovascular responses to high-dose corticosteroid therapy in canine endotoxin shock.
abstract: The neuroendocrine and cardiovascular responses to endotoxin administration and the effects of subsequent high-dose corticosteroid therapy have been investigated in dogs. Shock was induced in anaesthetised animals by a large bolus of E. coli endotoxin (5 mg/kg) followed by a continuous infusion (2 mg/kg per hour). One hour after induction of shock, the circulating volume was expanded using a colloidal gelatin solution. Fifteen minutes later, one group of five animals received a bolus of methylprednisolone sodium succinate 30 mg/kg, while a control group of five animals was given an equivalent volume of isotonic saline. The administration of endotoxin produced reductions in mean arterial pressure, cardiac index and left ventricular dp/dtmax, together with increases in systemic and pulmonary vascular resistances. These haemodynamic changes were associated with increases in arterial plasma levels of adrenaline, noradrenaline, cortisol, immunoreactive beta-endorphin and immunoreactive metenkephalin. Cardiovascular improvement followed volume replacement and was associated with reductions in circulating catecholamines. No significant haemodynamic or neuroendocrine changes were demonstrated in the 2 h following steroid therapy.
authors.affiliation: Anaesthetic Laboratory, St. Bartholomew's Hospital, London, UK.
authors.forename: J D
authors.initials: JD
authors.lastname: Watson
authors.forename: J G
authors.initials: JG
authors.lastname: Varley
authors.forename: S J
authors.initials: SJ
authors.lastname: Tomlin
authors.forename: S
authors.initials: S
authors.lastname: Medbak
authors.forename: L
authors.initials: L
authors.lastname: Perry
authors.forename: P M
authors.initials: PM
authors.lastname: Bouloux
authors.forename: L H
authors.initials: LH
authors.lastname: Rees
authors.forename: G M
authors.initials: GM
authors.lastname: Besser
authors.forename: C J
authors.initials: CJ
authors.lastname: Hinds
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects*; D004195:Disease Models, Animal; D004285:Dogs; D004731:Endotoxins; D004744:Enkephalin, Methionine / Q000097:blood; D004837:Epinephrine / Q000097:blood; D006321:Heart / Q000187:drug effects / Q000503:physiopathology*; D006854:Hydrocortisone / Q000097:blood; D008775:Methylprednisolone / Q000627:therapeutic use*; D009638:Norepinephrine / Q000097:blood; D011652:Pulmonary Circulation / Q000187:drug effects; D012016:Reference Values; D012772:Shock, Septic / Q000188:drug therapy* / Q000503:physiopathology; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D004731:Endotoxins; D004744:Enkephalin, Methionine; D006854:Hydrocortisone; D009638:Norepinephrine; D008775:Methylprednisolone; D004837:Epinephrine