The effect of intravenous steroids on alveolar-capillary membrane permeability in pulmonary acid injury.

Abstract

The treatment of pulmonary aspiration of gastric contents remains largely empirical. The purpose of the present study was to evaluate the effect of methylprednisolone administration (30 mg/kg) on alveolar-capillary membrane permeability after pulmonary acid aspiration in dogs. Alveolar-capillary membrane permeability was assessed by several methods. Extravascular lung water volume (EVLW), extravasation of 125I-serum albumin (RISA) into lung parenchyma, and albumin leak into the alveolar spaces were measured. EVLW increased progressively from 5.5 +/- 0.6 to 20.0 +/- 2.3 ml/kg in Group I (Acid) and from 5.4 +/- 1.2 to 22.1 +/- 3.1 ml/kg in Group II (Acid + Steroids) over the 5 hours after acid injury. The ratio of Lung Extravascular RISA to Plasma RISA was 0.56 +/- 0.14 and 0.58 +/- 0.14 in Group I and Group II, respectively (normal = 0.19 +/- 0.06). The tracheal albumin to plasma albumin ratio remained near 1.0 from 2 hours to 5 hours post-aspiration in both groups. This study demonstrated that pulmonary acid injury resulted in a marked increase in alveolar-capillary permeability to albumin, smaller solutes, and water which was not ameliorated by the administration of methylprednisolone.