Should Corticosteroids Be Used in Shock?

摘要: This paper analyzes the available information on possible mechanisms of corticosteroid action relevant to correction shock. Though shock may occur in a number diseases pathophysiological common denominator is inadequate tissue perfusion and its metabolic consequences: decreased pH PO2 PCO2 sodium increased lactic acid potassium magnesium fatty acids ketone bodies amino acids. The 4 proposed useful for treatment are: 1) Corticosteroids are required normal cardiac function their cradiovascular effects both intropic vascular (i.e. enhance catecholamines provide an adrenergic blockade); 2) stabilize membranes enhancing integrity capillaries affecting lysosomal membrane stability; 3) they improve metabolism; 4) also be terms other which include prevention breakdown direct detoxification endotoxin. toxicity administration corticosteroids discussed it pointed out that only benefit from demonstrated experimental situations occurred when large doses (more than 300 mg some up 1-2 gm. hydrocortisone or equivalent) were given at earliest decision point well before extremis but authors claim no position recommend specific agents dosage regimens clinical use.