Corticosteroids in the treatment of blunt injury of the chest.

In a prospective, controlled study, the effects of large doses of methylprednisolone sodium succinate (MP) were examined in patients subjected to severe blunt injury of the chest. Forty patients with multiple fractures of ribs were selected for the study. The majority of the patients had associated extrathoracic injuries. Chest X-ray films revealed changes characteristic of pulmonary contusion in all cases. Twenty patients were given MP 30 mg/kg body weight intravenously and were compared with 20 patients receiving no steroids, but who were otherwise treated identically. There were no differences between the two groups with respect to the A-VO2 difference and intrapulmonary shunting. However, the steroid treatment led to a significant reduction in pulmonary vascular resistance and to a reduction of the work of the right side of the heart. The number of complications and periods of artificial respiration were reduced in the steroid group. All patients survived.