Hill D G, Aguilar M J, Kosek J C, Hill J D
Ann Thorac Surg. 1976 Jul;22(1):36-40. doi: 10.1016/s0003-4975(10)63949-5.
A technique of inducing hypothermia using surface cooling and rewarming with a pump oxygenator has been applied clinically in infants with satisfactory results. Respiratory problems postoperatively, however, are reported to be among the complications contributing most to mortality and morbidity. Prednisolone sodium succinate (Solumedrol) has helped to obviate pulmonary damage in hemorrhagic and endotoxic shock and therefore may be effective in preventing pulmonary damage following hypothermia. This hypothesis was investigated in 12 mongrel puppies, 6 that had hypothermic cardiopulmonary bypass and circulatory arrest but were not given Solumedrol, and 6 that were treated preoperatively with Solumedrol. In lung biopsies taken immediately after bypass the pathological changes in both the group treated with steroids and the control group were similar. At six hours, however, lung biopsies from the control group showed further signs of progressive damage, while in the steroid-treated group there was a striking improvement with some lung biopsies showing a normal appearance. Thus, Solumedrol did not prevent initial lung damage, but the progressive and probably permanent changes were reduced.
一种使用体表降温及用泵氧合器复温来诱导体温过低的技术已在临床应用于婴儿，效果令人满意。然而，据报道术后呼吸问题是导致死亡率和发病率的主要并发症之一。琥珀酸氢化泼尼松（甲强龙）有助于避免出血性和内毒素性休克中的肺损伤，因此可能对预防体温过低后的肺损伤有效。在12只杂种幼犬中对这一假设进行了研究，6只进行了低温体外循环和循环停止但未给予甲强龙，另外6只在术前用甲强龙治疗。在体外循环后立即进行的肺活检中，使用类固醇治疗的组和对照组的病理变化相似。然而，在6小时时，对照组的肺活检显示出进一步的进行性损伤迹象，而在类固醇治疗组中则有显著改善，一些肺活检显示外观正常。因此，甲强龙并不能预防最初的肺损伤，但可减少进行性且可能是永久性的变化。
