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(Chest. 1970;57:440-453.)
© 1970 American College of Chest Physicians

Corticosteroids as Effective Vasodilators in the Treatment of Low Output Syndrome

Ronald H. Dietzman M.D.; Aldo R. Castaneda M.D., F.C.C.P.1; C. Walton Lillehei M.D., F.C.C.P.2; Robert A. Ersek M.D.3; George J. Motsay M.D.3; and Richard C. Lillehei M.D., F.C.C.P.4

1 Associate Professor of Surgery, University of Minnesota
2 Professor of Surgery, University of Minnesota; now Professor and Chairman, Department of Surgery, Cornell University, New York
3 Medical Fellow in Surgery, University of Minnesota
4 Professor of Surgery, University of Minnesota

The low output syndrome experimentally and clinically is expressed as a reduction in cardiac output associated with signs of peripheral vasoconstriction and reduced tissue perfusion. Experimentally in dogs methylprednisolone 30 mg/kg acts as a peripheral vasodilating drug with weak inotropic properties resulting in an increase in survival from 22 percent to 65 percent. Clinically methylprednisolone, 30 mg/kg, also acts as a peripheral vasodilating drug. When this drug is coupled with adequate volume replacement and the positive inotropic agent isoproterenol which are ineffective when given alone, 12 (63 percent) of 19 patients survived. This preliminary study underscores the effectiveness of this combined therapy in a usually lethal syndrome.




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