Survival of primates in lethal septic shock following delayed treatment with steroid.

We recently developed a methylprednisolone sodium succinate (MPSS)/gentamicin sulfate (GS) regimen that prevented death in baboons given a 2-hour infusion of LD100 E coli (J. Surg. Res. 28:151, 1980). Steroid treatment was begun in that study 30 minutes after initiation of E coli. Our current aim was to determine if baboons would survive if MPSs treatment was delayed until all E coli were infused and severe hypotension had ensued. Fourteen lightly anesthetized baboons (P.c. cynocephalus) were administered E. coli and seven were then treated with MPSS and GS for 10 hours. All nontreated baboons died, while six of seven treated animals survived. In the treated group, hypoglycemia and hypoinsulinemia were reversed, tachycardia was reduced and neutrophil recovery was improved. Baboons with delayed MPSS, however, evidenced diminished perfusion and recovered more slowly than those with earlier MPSs treatment. In conclusion, primates in septic shock are clearly protected with delayed steroid/antibiotic therapy.