Pulmonary granulocyte accumulation is reduced by nebulized corticosteroid in septic pigs

Nebulized beclomethasone dipropionate was administered to 14 anesthetized and artificially ventilated pigs at 6-hourly intervals after infusion of live S. aureus (BDP group). Changes in pulmonary activity from autologous granulocytes labeled with In-111 was detected externally for 12 (n = 8) to 44 h (n = 6). The changes were compared with those in ten pigs (12 h n = 7, 44 h n = 3) subjected to the same insults but given no corticosteroid (placebo group). Serial measurements of blood radioactivity, and cardiac output were performed in animals observed for 12 h. Corticosteroid-treated pigs showed a gradual decline in decay-corrected pulmonary In-111 activity. The placebo group displayed a more varied reaction, but most animals had an increased activity compared to the corticosteroid group. The difference between the groups was significant at 8 h (BDP-group 92% (88-98), placebo-group 107% (97-121), median (lower-upper quartiles), baseline = 100%. P < 0.01, U-test). Blood radioactivity and cardiac output did not differ significantly between the two groups. Nebulized corticosteroid thus diminished pulmonary granulocyte accumulation, which may be of value in the treatment of septic respiratory distress.