Use of methylprednisolone in patients following acute myocardial infarction. Hemodynamic and metabolic effects.

Abstract:

:Hemodynamic and metabolic effects of methylprednisolone were investigated in a double-blind study of 28 patients with acute myocardial infarction (AMI), confirmed by unequivocal electrocardiographic and enzyme changes. Measurements were performed prior to and at 1.5, 3, 4, 4.5, 12 and 24 hours following infusion of methylprednisolone (13 patients) or placebo (15 patients). Although systemic vascular resistance decreased from 1,750 to 1,420 dynes . sec . cm-5 (p less than .001) and cardiac index increased from 2.77 to 3.10 L/min/m2 (p less than .02) between 0 and 4.5 hours, an abnormal increase in blood lactate was observed in 10 of the 13 patients following administration of methylprednisolone (3.0 vs 1.2 mM/L, p less than .001). Lactate elevation appeared one hour after infusion of methylprednisolone, was maximal at 12 hours, and persisted for more than 24 hours. There was no significant change in blood lactate in placebo treated patients. A transient but significant decrease in plasma volume was also observed following infusions of methylprednisolone. The elevation of blood lactate could not be explained by the reduction in plasma volume since the most striking increases in lactate were observed 12 hours following the initial infusion of methylprednisolone when the plasma volume was returning to the control value. No significant differences in other hemodynamic or metabolic parameters, infarct size or patient survival were observed between the two groups. We conclude that the hemodynamic benefits of glucocorticoids characterized by increased cardiac output and lowered systemic vascular resistance are counterbalanced by the potentially unfavorable conditions of lactate elevation and volume depletion.

journal_name

Chest

journal_title

Chest

authors

Henning RJ,Becker H,Vincent JL,Thijs L,Kalter E,Weil MH

doi

10.1378/chest.79.2.186

subject

Has Abstract

pub_date

1981-02-01 00:00:00

pages

186-94

issue

2

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)60816-4

journal_volume

79

pub_type

临床试验,杂志文章,随机对照试验

相关文献

CHEST文献大全
  • Therapeutic potential of mesenchymal stem cells for severe acute lung injury.

    abstract::Preclinical studies indicate that allogeneic human mesenchymal stem cells (MSC) may be useful for the treatment of several clinical disorders, including sepsis, acute renal failure, acute myocardial infarction, and more recently, acute lung injury (ALI). This article provides a brief review of the biologic qualities o...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.10-0518

    authors: Matthay MA,Thompson BT,Read EJ,McKenna DH Jr,Liu KD,Calfee CS,Lee JW

    更新日期:2010-10-01 00:00:00

  • Anatomy and neurophysiology of cough: CHEST Guideline and Expert Panel report.

    abstract::Bronchopulmonary C-fibers and a subset of mechanically sensitive, acid-sensitive myelinated sensory nerves play essential roles in regulating cough. These vagal sensory nerves terminate primarily in the larynx, trachea, carina, and large intrapulmonary bronchi. Other bronchopulmonary sensory nerves, sensory nerves inn...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.14-1481

    authors: Canning BJ,Chang AB,Bolser DC,Smith JA,Mazzone SB,McGarvey L,CHEST Expert Cough Panel.

    更新日期:2014-12-01 00:00:00

  • Relationship of vancomycin minimum inhibitory concentration to mortality in patients with methicillin-resistant Staphylococcus aureus hospital-acquired, ventilator-associated, or health-care-associated pneumonia.

    abstract:BACKGROUND:Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and health-care-associated pneumonia (HCAP). These infections are associated with significant morbidity, mortality, and cost. The impact of vancomycin minimum inh...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.09-2453

    authors: Haque NZ,Zuniga LC,Peyrani P,Reyes K,Lamerato L,Moore CL,Patel S,Allen M,Peterson E,Wiemken T,Cano E,Mangino JE,Kett DH,Ramirez JA,Zervos MJ,Improving Medicine through Pathway Assessment of Critical Therapy of Hospital-Acqu

    更新日期:2010-12-01 00:00:00

  • Tamponade: Hemodynamic and Echocardiographic Diagnosis.

    abstract::Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise nonspecific features based on an understanding of the underlying pathophysiological characteristics....

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1016/j.chest.2017.11.003

    authors: Kearns MJ,Walley KR

    更新日期:2018-05-01 00:00:00

  • Variable severity of pulmonary disease in adults with identical cystic fibrosis mutations.

    abstract::Adults with CF followed in a university center were assessed for the presence of the most common CF gene mutation, delta-F508. Excluding one member of a sibling pair, 29 of 55 subjects had two copies of delta-F508 (homozygotes), 23 had one copy of delta-F508 with the other CF mutation not identified (complex heterozyg...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.102.2.506

    authors: Burke W,Aitken ML,Chen SH,Scott CR

    更新日期:1992-08-01 00:00:00

  • Pain and physical function are similar following axillary, muscle-sparing vs posterolateral thoracotomy.

    abstract:STUDY OBJECTIVES:We set out to determine whether there is a difference in postoperative pain and recovery after the patient undergoes the axillary muscle-sparing incision (ie, muscle-sparing thoracotomy [MT]) vs the modified posterolateral incision (ie, posterolateral thoracotomy [PT]). DESIGN:Analysis of a database o...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.128.4.2664

    authors: Ochroch EA,Gottschalk A,Augoustides JG,Aukburg SJ,Kaiser LR,Shrager JB

    更新日期:2005-10-01 00:00:00

  • Latent class analysis identifies distinct phenotypes of primary graft dysfunction after lung transplantation.

    abstract:BACKGROUND:There is significant heterogeneity within the primary graft dysfunction (PGD) syndrome. We aimed to identify distinct grade 3 PGD phenotypes based on severity of lung dysfunction and patterns of resolution. METHODS:Subjects from the Lung Transplant Outcomes Group (LTOG) cohort study with grade 3 PGD within ...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.12-1480

    authors: Shah RJ,Diamond JM,Cantu E,Lee JC,Lederer DJ,Lama VN,Orens J,Weinacker A,Wilkes DS,Bhorade S,Wille KM,Ware LB,Palmer SM,Crespo M,Localio AR,Demissie E,Kawut SM,Bellamy SL,Christie JD

    更新日期:2013-08-01 00:00:00

  • Oxidative stress after lung resection therapy: A pilot study.

    abstract:STUDY OBJECTIVES:To investigate whether oxidative stress occurs following lobectomy and pneumonectomy and to evaluate whether markers of oxidative stress might be of value in the assessment of the diagnosis, course, and prognosis of postoperative complications. DESIGN:A prospective study. SETTING:A specialized thorac...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.117.4.999

    authors: Lases EC,Duurkens VA,Gerritsen WB,Haas FJ

    更新日期:2000-04-01 00:00:00

  • Complications of corticosteroid therapy in patients with the acquired immunodeficiency syndrome and Pneumocystis carinii pneumonia.

    abstract::We retrospectively studied the acute toxicity of corticosteroid therapy in 23 episodes of PCP occurring in the setting of AIDS and determined the incidence of HIV-related complications following these and 16 other contemporaneous episodes of AIDS-related PCP treated with antimicrobials alone. The mean duration of cort...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.1.38

    authors: Lambertus MW,Goetz MB,Murthy AR,Mathisen GE

    更新日期:1990-07-01 00:00:00

  • Sulfasalazine-induced pulmonary disease.

    abstract::We report the findings in two patients with sulfasalazine-induced pulmonary disease. The first patient developed pulmonary interstitial fibrosis after more than 4 yr of treatment for Crohn's disease. Pulmonary symptoms and chest roentgenographic and pulmonary function abnormalities gradually reversed after stopping th...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.101.4.1033

    authors: Hamadeh MA,Atkinson J,Smith LJ

    更新日期:1992-04-01 00:00:00

  • Racial differences in physiologic parameters related to asthma among middle-class children.

    abstract:BACKGROUND:Asthma morbidity and mortality are higher in the United States for African-American (AA) children when compared to European-American (EA) children. STUDY OBJECTIVES:To explore racial differences in physiologic factors associated with pediatric asthma severity. DESIGN:Cross-sectional. METHODS:We analyzed d...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.117.5.1336

    authors: Joseph CL,Ownby DR,Peterson EL,Johnson CC

    更新日期:2000-05-01 00:00:00

  • Intra- and interobserver variations in the measurement of systolic time intervals.

    abstract::Intra- and interobserver variations in the measurement of systolic time intervals (STIs) by three experienced cardiologists were investigated in 20 tracings on which phonocardiograms, carotid pulse and electrocardiograms were recorded simultaneously. The STIs studied were the time interval from the Q wave to the aorti...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.81.3.341

    authors: Ishikawa K,Ishikawa M,Morihara H,Yanagisawa A,Muramatsu J,Sawayama T,Maeda K

    更新日期:1982-03-01 00:00:00

  • Thoracic splenosis presenting with hemoptysis.

    abstract::Thoracic splenosis (post-traumatic autotransplantation of splenic tissue) is rare and generally asymptomatic. We report a patient with thoracic splenosis presenting with repeated hemoptysis. The blood supply of the hypervascular splenic transplants originated from a bronchial and an intercostal artery. Hemoptysis impr...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.102.2.626

    authors: Cordier JF,Gamondes JP,Marx P,Heinen I,Loire R

    更新日期:1992-08-01 00:00:00

  • Positional dyspnea and oxygen desaturation related to carcinoma of the lung. Up with the good lung.

    abstract::Body position can lead to respiratory symptoms and affect gas exchange in disease states. We describe a patient with carcinoma of the left lung in whom dyspnea and oxygen desaturation developed in the right lateral position only. Fiberoptic bronchoscopic study demonstrated a tumor mass protruding into the left main-st...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.83.5.826

    authors: Mahler DA,Snyder PE,Virgulto JA,Loke J

    更新日期:1983-05-01 00:00:00

  • Is metalloproteinase-7 specific for idiopathic pulmonary fibrosis?

    abstract:BACKGROUND:Matrix metalloproteinase (MMP)-7 was reported to be a key molecule in the pathogenesis of idiopathic pulmonary fibrosis (IPF) based on the result of microarray analysis and knockout mice. However, the role of MMP-7 has not been determined in other types of idiopathic interstitial pneumonia (IIP). The aim of ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.07-2116

    authors: Huh JW,Kim DS,Oh YM,Shim TS,Lim CM,Lee SD,Koh Y,Kim WS,Kim WD,Kim KR

    更新日期:2008-05-01 00:00:00

  • Physiologic benefits of mechanical insufflation-exsufflation in children with neuromuscular diseases.

    abstract:STUDY OBJECTIVES:To analyze the physiologic effects and tolerance of mechanical insufflation-exsufflation (MI-E) by means of mechanical cough assistance (Cough Assist; JH Emerson Company; Cambridge, MA) for children with neuromuscular disease. DESIGN:Prospective clinical trial. SETTING:Physiology laboratory of a pedi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.07-1615

    authors: Fauroux B,Guillemot N,Aubertin G,Nathan N,Labit A,Clément A,Lofaso F

    更新日期:2008-01-01 00:00:00

  • The effects of helium-hyperoxia on 6-min walking distance in COPD: a randomized, controlled trial.

    abstract:BACKGROUND:We hypothesized that breathing helium-hyperoxia (HeO2) would significantly improve 6-min walking test (6MWT) distance in COPD subjects. METHODS:This was a blinded, randomized crossover study. At visit 1, we assessed pulmonary function, exercise capacity, and 6MWT distance. Visits 2 and 3 consisted of four 6...

    journal_title:Chest

    pub_type: 杂志文章,随机对照试验

    doi:10.1378/chest.06-2514

    authors: Marciniuk DD,Butcher SJ,Reid JK,MacDonald GF,Eves ND,Clemens R,Jones RL

    更新日期:2007-06-01 00:00:00

  • Portable monitors in the diagnosis of obstructive sleep apnea.

    abstract::The use of portable monitors (PM) devices has been demonstrated in a wide variety of investigational settings with varying results. While most devices correlate very well with in-laboratory polysomnography, some still misclassify a significant numbers of patients and have lower sensitivity. In addition, the failure ra...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.06-2793

    authors: Ahmed M,Patel NP,Rosen I

    更新日期:2007-11-01 00:00:00

  • Pulmonary hypertension secondary to thrombocytosis in a patient with myeloid metaplasia.

    abstract::A 72-year-old physician with myeloid metaplasia developed marked thrombocytosis, pulmonary hypertension, and right heart failure following splenectomy. No cause for the pulmonary hypertension could be found. The pulmonary hypertension and right heart failure returned to normal when hydroxyurea therapy corrected the th...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.2.642

    authors: Marvin KS,Spellberg RD

    更新日期:1993-02-01 00:00:00

  • The cardiovascular effects of acute hypoxemia as a diagnostic aid.

    abstract::Acute hypoxemia produces opposite effects on the pulmonary and systemic vascular resistance. To assess the influence of acute hypoxemia on cardiac murmurs, 36 patients with a single valvular or congenital heart lesion were studied. As expected from these hemodynamic effects, right-sided regurgitant type murmurs increa...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.81.2.159

    authors: Curiel R,Tortoledo F,Rodriguez L,Soto R,Perez-Gonzalez J

    更新日期:1982-02-01 00:00:00

  • Validation of the Exhaled Breath Temperature Measure: Reference Values in Healthy Subjects.

    abstract:BACKGROUND:Exhaled breath temperature (EBT) is a new noninvasive method for the study of inflammatory respiratory diseases with a potential to reach clinical practice. However, few studies are available regarding the validation of this method, and they were mainly derived from small, pediatric populations; thus, the ra...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2016.11.013

    authors: Carpagnano GE,Foschino-Barbaro MP,Crocetta C,Lacedonia D,Saliani V,Zoppo LD,Barnes PJ

    更新日期:2017-04-01 00:00:00

  • Effect of dry warm air on respiratory water loss in children with exercise-induced asthma.

    abstract::The variation in respiratory water loss (RWL) over time, expressed as the mass of water vapor lost per liter (body temperature and pressure, saturated) of ventilation (MH2O), was investigated in two groups: (1) children with exercise-induced asthma; and (2) healthy children. Children were matched for age and sex and w...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.94.1.81

    authors: Tabka Z,Ben Jebria A,Vergeret J,Guenard H

    更新日期:1988-07-01 00:00:00

  • Usual interstitial pneumonia associated with primary Sjögren's syndrome.

    abstract::We describe the first case, to our knowledge, of usual interstitial pneumonia (UIP) as the pulmonary manifestation in primary Sjögren's syndrome (SjS). A 45-year-old woman was admitted to our hospital because of a dry cough and an interstitial shadow on a chest roentgenogram. Labial biopsy and sialogram confirmed a di...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.108.6.1756

    authors: Kadota J,Kusano S,Kawakami K,Morikawa T,Kohno S

    更新日期:1995-12-01 00:00:00

  • Time-dependent effect of nitrate-rich meals on exhaled nitric oxide in healthy subjects.

    abstract:BACKGROUND:Exhaled nitric oxide (eNO) is a convenient noninvasive marker for airway inflammation in several pulmonary diseases. However, external factors such as nitrate-rich nutrition can affect the levels of eNO and thus compromise its diagnostic value. STUDY OBJECTIVES:The objective of this investigation was to hav...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.4.2465

    authors: Vints AM,Oostveen E,Eeckhaut G,Smolders M,De Backer WA

    更新日期:2005-10-01 00:00:00

  • Needle aspiration biopsy of malignant lung masses with necrotic centers. Improved sensitivity with ultrasonic guidance.

    abstract::False-negative results from transthoracic needle aspiration biopsy of malignant lung masses may occur if a central necrotic area is present and is the source of the biopsy material. The purpose of this study is to determine if the use of ultrasonic guidance can improve the sensitivity of lung needle biopsies in this c...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.5.1452

    authors: Pan JF,Yang PC,Chang DB,Lee YC,Kuo SH,Luh KT

    更新日期:1993-05-01 00:00:00

  • Diagnostic value of interferon-gamma in tuberculous pleurisy: a metaanalysis.

    abstract:BACKGROUND:Conventional tests are not always helpful in making a diagnosis of tuberculous pleurisy. Many studies have investigated the usefulness of interferon (IFN)-gamma measurements in pleural fluid for the early diagnosis of tuberculous pleurisy. We conducted a metaanalysis to determine the accuracy of IFN-gamma me...

    journal_title:Chest

    pub_type: 杂志文章,meta分析,评审

    doi:10.1378/chest.06-2273

    authors: Jiang J,Shi HZ,Liang QL,Qin SM,Qin XJ

    更新日期:2007-04-01 00:00:00

  • Skin sensitivity to histolyn, spherulin, and PPD in the People's Republic of China.

    abstract::One hundred one subjects living in northwest Hunan Province, People's Republic of China (PRC) were tested with histolyn, (Berkeley Biological Laboratories), spherulin (Berkeley Biological Laboratories), and tubersol (PPD 5 tuberculin units, Connaught Laboratories). Age of the tested subjects ranged from 16 to 58 years...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.6.1356

    authors: Baum GL,Wu JN,Hua SS,Baum C,Ajello L

    更新日期:1990-06-01 00:00:00

  • Obstructive sleep apnea and resistant hypertension: a case-control study.

    abstract:BACKGROUND:Obstructive sleep apnea syndrome (OSAS) has been linked to resistant hypertension, but the magnitude of this association and its independence of confounding have not been established. METHODS:Case patients were 63 patients with resistant hypertension (BP >or= 140/90 mm Hg using at least three BP-lowering dr...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.07-1170

    authors: Gonçalves SC,Martinez D,Gus M,de Abreu-Silva EO,Bertoluci C,Dutra I,Branchi T,Moreira LB,Fuchs SC,de Oliveira AC,Fuchs FD

    更新日期:2007-12-01 00:00:00

  • The right ventricle explains sex differences in survival in idiopathic pulmonary arterial hypertension.

    abstract:BACKGROUND:Male sex is an independent predictor of worse survival in pulmonary arterial hypertension (PAH). This finding might be explained by more severe pulmonary vascular disease, worse right ventricular (RV) function, or different response to therapy. The aim of this study was to investigate the underlying cause of...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.13-1291

    authors: Jacobs W,van de Veerdonk MC,Trip P,de Man F,Heymans MW,Marcus JT,Kawut SM,Bogaard HJ,Boonstra A,Vonk Noordegraaf A

    更新日期:2014-06-01 00:00:00

  • Congenital unilateral absence of the left pulmonary artery. Echocardiography in reverse.

    abstract::This study demonstrates that when the heart is markedly displaced posteriorly to the left, or perhaps to the right, the posterior approach may make echocardiographic evaluation possible. Thus, in a patient with congenital unilateral absence of the left pulmonary artery, with marked displacement of the heart posteriorl...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.77.1.106

    authors: Borgeson E,Vogel JH

    更新日期:1980-01-01 00:00:00