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J Trauma. 1976 Jul;16(7):543-9.

Pulmonary function in patients with multiple trauma and associated severe head injury.


1) Sodium and water balance and pulmonary function studies were obtained in five patients with multiple injuries, including pulmonary contusion, plus severe intracranial trauma. All patients received dexamethasone, 4-6 every 6 hours during the 72-hour study period after injury. 2) Results were compared with those from 14 previously reported patients without head injury; none had received corticosteroids. 3) Study patients with head injury achieved negative water balance and almost-zero sodium balance within 72 hours of injury be excreting a high-volume, low-sodium urine. Despite elevated alveolar-arterial oxygen gradients and low-normal pulmonary compliance initially, there was progressive improvement and no patient developed post-traumatic pulmonary insufficiency. 4) The data suggest that the "negative" effects of major intracranial trauma on the kidney, heart, and lung are cancelled by dexamethasone, or that corticosteroids protect pulmonary function in the patient with multiple injuries and prevent post-traumatic pulmonary insufficiency, perhaps through their effect on the kidney leading to rapid restoration of sodium and water balance.

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