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Early hydrocortisone treatment counteracts circulatory derangement but not cytokine response in porcine endotoxemia

Introduction

We evaluated whether treatment with hydrocortisone administered just after establishment of endotoxin-mediated circulatory dysfunction would have anti-inflammatory and shock reversing effects. Establishment of endotoxin-mediated circulatory dysfunction was defined as the moment when the mean pulmonary arterial pressure (MPAP) reached the double baseline value.

Methods

All pigs were anesthetized and given endotoxin infusion during the 6 hours of the experiment. Eight pigs were randomized to the hydrocortisone group, receiving hydrocortisone at 5 mg/kg intravenously, or to the control group, receiving a corresponding volume of saline, as soon as the MPAP doubled the baseline value. P < 0.05 was considered significant.

Results

No difference in baseline data was noted between the groups. No differences in TNFα (Figure 1), IL-6 and core temperature were seen between the groups. Pigs in the hydrocortisone group had significantly higher mean arterial pressure and systemic vascular resistance index during the 6-hour experimental period than pigs in the control group, while heart rate was significantly lower in the hydrocortisone group at 1 to 6 hours as compared with controls.

Figure 1
figure1

TNFα over time (mean ± SEM).

Conclusions

Early treatment with hydrocortisone, administered after the onset of endotoxemia, counteracted circulatory deterioration, but did not affect the plasma levels of proinflammatory cytokines in this model. Thus, TNFα and IL-6 might not be involved in the development of circulatory dysfunction during the early phase of experimental endotoxemia.

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Correspondence to ES Söderberg.

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Söderberg, E., Lipcsey, M., Sjölin, J. et al. Early hydrocortisone treatment counteracts circulatory derangement but not cytokine response in porcine endotoxemia. Crit Care 14, P18 (2010). https://doi.org/10.1186/cc8250

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Keywords

  • Hydrocortisone
  • Arterial Pressure
  • Core Temperature
  • Resistance Index
  • Systemic Vascular Resistance