[Corticoids and shock].

Abstract

After recalling the major role of catecholamines in the genesis of irreversible shock, the anti-shock action of glucocorticosteroids, owing to properties which are "alpha-blocking" , is discussed in this work. The works of LILLEHEI on the effectiveness of corticosteroids in different types of shock are summarized and discussed, as well as numerous works which have followed and a synopsis of which, done in 1967 in the "Annales de l'Anesthésiologie Francaise", is presented. Since then, following new experimental facts, whereas numerous contradictions have appeared in the clinical and experimental realms, the possible mechanisms of action of corticosteroids in shock are looked at, by emphasizing the relationships between corticosteroids and SHWARTZMAN's phenomenon, in particular. A hypothesis on a probable central action of glucocorticosteroids is proposed following experimental works carried out by H. LABORIT et Coll. (1975). Finally, the author presents a personal experiment in hemorrhagic shock in the rabbit where the adjunction of corticosteroids had no effect on the different parameters such as the decrease in PaCO2, hyperlactacidemia and the liberation of beta-glycuronidase in the blood, mortality being practically the same in the controls and in the animals submitted to corticosteroid therapy.