Hemodynamic effects of high doses of corticosteroids

It is somewhat difficult to reconcile the contrasting findings regarding the hemodynamic actions of high doses of corticosteroids in shock. The studies differ according to type of shock (hypovolemic, septic or cardiogenic), animal species, shock model, type of corticosteroid, etc. Beneficial hemodynamic effects (e.g. myocardial improvement, vasodilation) of steroids given alone are not consistently observed and when so often mild and transient. This might indicate that the hemodynamic changes of corticosteroids are not due to primary actions on the cardiovascular system but rather represent the hemodynamic consequences of the metabolic response to corticosteroid therapy. If, however, the corticosteroid therapy is combined with an alpha-adrenoreceptor blocker the nutritive tissue blood flow is distinctly increased.