Effects of Progesterone on the Ventilatory Performance in Adult Trauma Patients during Partial Support Mechanical Ventilation

Background: Previous studies have shown that progesterone increases the ventilatory performance in healthy individuals and in patients with chronic obstructive pulmonary disorders. The study was designed to investigate the effect of a single intramuscular administration of progesterone on ventilatory performance in adult trauma patients during partial support mechanical ventilation. Methods: Forty adult trauma patients undergoing partial support mechanical ventilation with a spontaneous minute ventilation of 30 – 50% of their total minute ventilation were randomly given a single intramuscular injection of either progesterone 1 mg/kg or normal saline as placebo. Airway resistance and pressure, lung compliance, spontaneous tidal volume and respiratory rate, pulse oxymetric oxygen saturation, end tidal CO2 concentration, heart rate, and blood pressure were measured and compared between two groups before administration of progesterone (or placebo) and three and six hours after it. Results: Three hours after progesterone administration maximum negative inspiratory pressure, spontaneous tidal volume, dynamic compliance, and oxygen saturation were increased while peak airway pressure, airway resistance, and end tidal CO2 concentration decreased significantly compared to the basal values and those in the placebo group. These changes returned to baseline between three to six hours after progesterone administration. Conclusion: The results of this study show the beneficial effect of a single intramuscular administration of progesterone on the ventilatory performance during partial support mechanical ventilation, which lasts for three to six hours. Whether more frequent administration of progesterone is of value for the management of mechanical ventilation and in particular the weaning process, remains to be elucidated in future studies.