[Effect of glucocorticoids on extravascular lung water following extra-corporeal circulation].
The influence of 3 different, preoperatively given glucocorticoids (30 mg/kg bw methylprednisolone, 3 mg/kg bw dexamethasone, 30 mg/kg hydrocortisone) on extravascular lung water (EVLW) was investigated in a randomised study consisting of 60 patients undergoing elective aortocoronary bypass surgery and compared to a control group having received 0.9% NaCl as placebo. EVLW-measurements were performed by using the double indicator dilution technique with indocyanine green and a microprocessed lung water computer. Besides EVLW-measurements haemodynamics and various laboratory data were studied before as well as after (15 min, 45 min, 5 h) extracorporeal circulation (ECC). ECC was followed by an increase in EVLW, which was less pronounced in the dexamethasone-group without being statistically significant (p = 0.1), however. Pulmonary gas exchange, too, did not differ statistically, in spite of a less pronounced (p = 0.1) deterioration of paO2 in the dexamethasone-group. Haemodynamics and laboratory data in the corticoid-group did not show any significant difference compared to the non-treated control group. It was concluded, that pretreatment with corticoids in pharmacological doses in cardiac surgery had no beneficial effects on extravascular lung water and pulmonary function.
D002199:Capillary Permeability / Q000187:drug effects; D001026:Coronary Artery Bypass; D003907:Dexamethasone / Q000627:therapeutic use; D005110:Extracellular Space / Q000187:drug effects*; D005112:Extracorporeal Circulation; D005938:Glucocorticoids / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008168:Lung / Q000187:drug effects*; D008775:Methylprednisolone / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D011292:Premedication; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D012128:Respiratory Distress Syndrome / Q000517:prevention & control*; D014882:Water-Electrolyte Balance / Q000187:drug effects
D005938:Glucocorticoids; D003907:Dexamethasone; D006854:Hydrocortisone; D008775:Methylprednisolone
Der Einfluss von Glucocorticoiden auf das extravasculäre Lungenwasser nach extracorporaler Zirkulation.