THE EFFECT OF METHYLPREDNISOLONE ON MYOCARDIAL BETA-ADRENERGIC RECEPTORS AND CARDIOVASCULAR FUNCTION IN SHOCK PATIENTS

The effect of methylprednisolone on the myocardial beta-adrenergic rec eptors after long term (>72 h) catecholamine infusion was studied. In 56 patients with pulmonary arterial catheter, 10 mg/kg of methylpredni solone was given as an intravenous bolus. Significant increases could be seen in cardiac output and blood pressure in patients who were simu ltaneously treated with vasopressors like dopamine and/or dobutamine. In patients who were on dopamine infusion higher than 10 mu g/kg/min m ethylprednisolone there was an increase in the systemic vascular resis tance. Patients who were not on vasopressors but received methylpredni solone, had no similar changes in hemodynamic parameters. In an in vit ro analysis of tissue from the myocardium in 12/56 patients who succum bed and in four additional patients who expired after multiple trauma, a beta-adrenergic receptor assay was performed. It was found that the long term infusion of catecholamines decreased the receptor number an d the methylprednisolone abolished or caused the decrease to be less p ronounced. In this study we could not control the selection of the pat ients; a randomized study needs to be conducted in the future.