Literature DB >> 1934222

Prostanoid production and pulmonary hypertension after fat embolism are not modified by methylprednisolone.

R J Byrick1, J B Mullen, P Y Wong, J C Kay, D Wigglesworth, R J Doran.   

Abstract

Bilateral cemented arthroplasty (BCA) in anaesthetized mongrel dogs produces particulate fat and marrow embolism of the lung. Methylprednisolone sodium succinate (MPSS) has been advocated for post-traumatic fat embolism to prevent acute lung injury. We used the BCA procedure to produce acute fat and marrow embolism, and tested the efficacy of MPSS (30 mg.kg-1) in preventing physiological and pathological markers of acute lung injury. Dogs (n = 6) pre-treated with MPSS demonstrated similar acute increases in pulmonary artery pressure (PAP) within one minute of BCA (17.8 +/- 7.3 mmHg) as the untreated (control n = 7) dogs (18.6 +/- 12.6). Pulmonary vascular resistance (PVR) increased to the same degree in both groups (455 +/- 323 and 319 +/- 137 dyne.sec.cm-5) and PaO2 decreased by 18.3 +/- 6.4 mmHg in the control group as opposed to 12.4 +/- 7.7 mmHg in the MPSS group within five minutes of BCA. Circulating arterial and mixed venous plasma concentrations of thromboxane B2 (TxB2) increased within one minute of BCA in both groups with no increase in the transpulmonary gradient. Arterial plasma 6-keto prostaglandin F1 alpha (6-keto PGF1 alpha) increased (0.91 +/- 0.29 ng.ml-1 and 0.87 +/- 0.43 ng.ml-1) in both groups one minute after BCA. Mixed venous 6-keto PGF1 alpha plasma concentration also increased, but a significant transpulmonary 6-keto PGF1 alpha gradient was found.(ABSTRACT TRUNCATED AT 250 WORDS)

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Year:  1991        PMID: 1934222     DOI: 10.1007/BF03008205

Source DB:  PubMed          Journal:  Can J Anaesth        ISSN: 0832-610X            Impact factor:   5.063


  25 in total

Review 1.  Pharmacologic modulation of lung injury.

Authors:  S I Said; H D Foda
Journal:  Am Rev Respir Dis       Date:  1989-06

2.  High-volume, high-pressure pulsatile lavage during cemented arthroplasty.

Authors:  R J Byrick; R S Bell; J C Kay; J P Waddell; J B Mullen
Journal:  J Bone Joint Surg Am       Date:  1989-10       Impact factor: 5.284

3.  Cardiovascular effects of acrylic bone cement in rabbits and cats.

Authors:  D Pelling; K R Butterworth
Journal:  Br Med J       Date:  1973-06-16

4.  Morphometric estimation of pulmonary diffusion capacity. IV. The normal dog lung.

Authors:  B Siegwart; P Gehr; J Gil; E R Weibel
Journal:  Respir Physiol       Date:  1971-11

5.  Blood pressure and bone cement.

Authors:  R S Ling; M L James
Journal:  Br Med J       Date:  1971-05-15

Review 6.  Eleventh Gaddum memorial lecture. Lipocortin and the mechanism of action of the glucocorticoids.

Authors:  R J Flower
Journal:  Br J Pharmacol       Date:  1988-08       Impact factor: 8.739

Review 7.  Pulmonary microembolism.

Authors:  A B Malik
Journal:  Physiol Rev       Date:  1983-07       Impact factor: 37.312

8.  'Low-dose' corticosteroid prophylaxis against fat embolism.

Authors:  J Kallenbach; M Lewis; M Zaltzman; C Feldman; A Orford; S Zwi
Journal:  J Trauma       Date:  1987-10

9.  Air embolism during total hip replacement: comparison of two surgical techniques.

Authors:  R D Evans; M G Palazzo; J W Ackers
Journal:  Br J Anaesth       Date:  1989-03       Impact factor: 9.166

10.  Early steroid therapy for respiratory failure.

Authors:  J A Weigelt; J F Norcross; K R Borman; W H Snyder
Journal:  Arch Surg       Date:  1985-05
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