Objective: To see if treatment with a combination of drugs each directed at a different mediator was successful in preventing activation of those mediators in experimental endotoxic shock.
Design: Controlled study.
Material: 40 juvenile pigs.
Interventions: 33 animals received 0.01 mg/kg endotoxin infusion, the rest being given the same volume of saline; 10 of the 33 received no treatment. Of the remaining 23, 5 were given combination treatment with methylprednisolone, naloxone, ketanserin, promethazine, C1 esterase inhibitor, antithrombin III and aprotinin; 7 were given methylprednisolone only; 6 were given the three protease inhibitors (C1 esterase inhibitor, antithrombin III and aprotinin); and 5 were given naloxone, ketanserin and promethazine.
Main outcome measures: Assessment of haemodynamic, proteolytic, and cellular effects of endotoxaemia.
Results: Only the combination treatment totally blocked all the effects of the infusion of endotoxin.
Conclusion: As endotoxin affects several mediators, combination treatment is necessary to block all its deleterious effects in pigs.