Peitzman A B, Shires G T, Illner H, Shires G T
J Trauma. 1982 May;22(5):347-52. doi: 10.1097/00005373-198205000-00001.
The treatment of pulmonary aspiration of gastric contents remains largely empirical. The purpose of the present study was to evaluate the effect of methylprednisolone administration (30 mg/kg) on alveolar-capillary membrane permeability after pulmonary acid aspiration in dogs. Alveolar-capillary membrane permeability was assessed by several methods. Extravascular lung water volume (EVLW), extravasation of 125I-serum albumin (RISA) into lung parenchyma, and albumin leak into the alveolar spaces were measured. EVLW increased progressively from 5.5 +/- 0.6 to 20.0 +/- 2.3 ml/kg in Group I (Acid) and from 5.4 +/- 1.2 to 22.1 +/- 3.1 ml/kg in Group II (Acid + Steroids) over the 5 hours after acid injury. The ratio of Lung Extravascular RISA to Plasma RISA was 0.56 +/- 0.14 and 0.58 +/- 0.14 in Group I and Group II, respectively (normal = 0.19 +/- 0.06). The tracheal albumin to plasma albumin ratio remained near 1.0 from 2 hours to 5 hours post-aspiration in both groups. This study demonstrated that pulmonary acid injury resulted in a marked increase in alveolar-capillary permeability to albumin, smaller solutes, and water which was not ameliorated by the administration of methylprednisolone.
