Progesterone administration after trauma and hemorrhagic shock improves cardiovascular responses

Abstract

Because administration of progesterone after trauma-hemorrhage in sex steroid-deficient females improved cardiovascular responses, this hormone seems to be a useful adjunct for the treatment of cardiovascular depression in postmenopausal and ovariectomized female trauma patients.

A Role of PPAR-?? in Androstenediol-Mediated Salutary Effects on Cardiac Function Following Trauma-Hemorrhage

“…2,3 It has been reported that systemic IL-6 levels increase following traumahemorrhage (T-H), and a sustained elevation in plasma IL-6 levels is correlated with the evolving organ dysfunction. [4][5][6] Clinical data also confirmed that the increased IL-6 production is associated with poor outcome in patients with trauma or hemorrhagic shock. 7 IL-6 has been described as a multifunctional cytokine, produced during the acute phase by macrophages, T and B cells, and nonimmune cells such as myocytes or endothelial cells.…”

“…11 In line with these findings, previous studies from our laboratory have shown that cardiac dysfunction was associated with elevated plasma IL-6 levels. 6,[13][14][15] Furthermore, our recent study suggested that the depressed cardiac function following T-H is associated with an increase in cardiomyocyte IL-6 production. 16 The causal role of IL-6 in producing organ dysfunction has been further substantiated by studies which showed that administration of anti-IL-6 antibodies results in improved organ function following T-H. 17 The peroxisome proliferator-activated receptor-gamma (PPAR-␥), a member of the nuclear hormone receptor superfamily, was originally reported to have a role in adipocyte differentiation and glucose homeostasis.…”

Multifunctional Drugs for Head Injury

“…97 Related studies demonstrated that progesterone attenuated the cardiovascular depression and significantly improved cardiac output and heart performance and increased circulating blood volume. 98 These combined systemic effects of progesterone may be particularly beneficial in TBI victims with multisystem trauma, a common occurrence in motor vehicle accidents but frequently not accounted for in clinical trails.…”

Female Sex Hormones Protect Red Blood Cells from Damage after Trauma-Hemorrhagic Shock

“…The same deleterious effects of oophorectomy have been observed in proestrus female rats subjected to T/HS by the administration of an estrogen receptor antagonist during resuscitation [25]. Further support for the protective role of female sex hormones comes from studies showing that the impaired cardiovascular and hepatic function observed in oophorectomized rats subjected to T/HS can be restored by the administration of estrogens [24] as well as progesterone [26]. In fact, Jarrar et al demonstrated that coadministration of the estrogen receptor antagonist ICI 182,780, and estrogens abolishes the beneficial effect of estrogens [24].…”