Mar 1, 1995

Corticosteroid effect on early beta-adrenergic down-regulation during circulatory shock: hemodynamic study and beta-adrenergic receptor assay

Intensive Care Medicine
T SaitoR Ogawa

Abstract

The steroid effect on critically ill patients remains controversial. The aim of this study is to characterize the effect of methylprednisolone on the heart in a beta-adrenergically down-regulated condition. A prospective hemodynamic study and retrospective receptor assay. Multidisciplinary ICU in a university hospital. 42 patients who required pulmonary arterial catheters and an additional 4 corpses who were available for study within 3 h of their deaths. Intravenous methylprednisolone (10 mg/kg). We pursued a hemodynamic study following a glucocorticoid administration. In patients who had undergone a long term (> 72 h) catecholamine treatment, the cardiac index increased. In patients who had undergone a short term (1-72 h) catecholamine treatment and in patients with no record of catecholamine administration, the cardiac index showed no remarkable change. Among the corpses, who died soon after their arrival, and the patients, who later died in the ward and were available for further study, we measured beta-adrenergic receptor density in the left ventricular myocardium. It was found that receptor density was decreased after long term catecholamine treatment. Methylprednisolone, on the other hand increased the receptor density. ...Continue Reading

Mentioned in this Paper

Lung
Myocardium of Left Ventricle
Catecholamine [EPC]
Intravenous Injections
Corticosteroid [EPC]
Receptor Down-Regulation
Myocardium
Shock
Etiology
ADRB2 gene

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