Amelioration of the pulmonary effects of massive autotransfusion with corticosteroids in the dog.

In this study, pulmonary changes were investigated following massive autotransfusion with local anticoagulation as well as whether or not corticosteroids would provide a protective effect. Twenty mongrel dogs were bled into the peritoneal cavity and autotransfused with the Sorenson system for a total of twice their blood volume. Blood was reinfused by means of 40 micron effective filters. Ten dogs were given 30 milligrams per kilogram of methylprednisolone sodium succinate at the time that autotransfusion was begun. Dogs of the control group had a decrease in cardiac output and oxygen delivery. Steroid-treated dogs had insignificant hemodynamic changes. Both groups showed a slight rise in pulmonary vascular resistance, but the arterial pO2 and pCO2 were unaltered. Two independent pathologists, in a blind study, examined the upper lobe of the left lung for hemorrhage, congestion, edema and fibrin thrombi. Nine of ten dogs in the control study had marked changes. A similar degree of alteration was recorded in only five of ten dogs in the steroid treated group. Corticosteroids mitigated the deleterious effects of massive autotransfusion in a canine model, and this may indicate their use in the critically injured patients undergoing this procedure.