Quote Originally Posted by FrostyPaws View Post
I think I may start paying for some of those articles so I can just flat out have them on hand for future reference. Either way, it is something to seriously ponder. Have people been doing it wrong for so long?

I found some studies from the 70s that advocate the use of dex in hemorrhagic shock.

70s Shock
70s Shock x2

Interesting, thanks.

Again, the dosages in almost every government/university reference are exactly at the high-end of the dosage range.

(If you decide to buy the paid-for articles, let us know what the finding are.)

Here are some current findings I found for Solu-Medrol:

Solu-Medrol (Pfizer) Package Label.
"Shock: In severe hemorrhagic or traumatic shock, adjunctive use of i.v. methylprednisolone may aid in achieving hemodynamic restoration. [Although there are no well-controlled (double-blind placebo) clinical trials, data from experimental animal models indicate that methylprednisolone may be useful in hemorrhagic and traumatic shock. See also Warnings regarding septic shock.] Corticoid therapy should not replace standard methods of combatting shock, but present evidence indicates that concurrent use of large doses of corticoids with other measures may improve survival rates."

And another (New Zealand Govt)
"As adjunctive therapy in life threatening conditions (e.g. shock states) the recommended dose of Methylprednisolone is 30 milligrams per kg of methylprednisolone sodium succinate, given IV over a period of at least 30 minutes. This dose may be repeated every 4 to 6 hours for up to 48 hours."

US FDA Statement on Solu-Delta
"There are reports of cardiac arrhythmias and/or cardiac arrest following the rapid administration of large IV doses of SOLU-MEDROL (greater than 0.5 gram administered over a period of less than 10 minutes). Bradycardia has been reported during or after the administration of large doses of methylprednisolone sodium succinate, and may be unrelated to the speed or duration of infusion. When high dose therapy is desired, the recommended dose of SOLU-MEDROL Sterile Powder is 30 mg/kg administered intravenously over at least 30 minutes. This dose may be repeated every 4 to 6 hours for 48 hours."

This is probably why Doc recommended it just be mixed with the bag of fluids, rather than run straight into the vein.

And I also think this almost universal adherence to the high-end of the range, for traumatic shock, is why Doc originally placed the dosages right at that high-end and left out the "ranges" ...

Jack