The effects of prostaglandin E1 (PGE1) on the adult respiratory distress syndrome were studied in the septic primate (Macaca fascicularis). A 30-min infusion of Escherichia coli (1 X 10(10)/kg) resulted in severe septic shock and adult respiratory distress syndrome. Primates, if living, were killed 4 h after completion of the E. coli infusion. Three groups of primates were studied (n = 4 in each group). The control group (Group 1) received PGE1 at 100 ng/kg/min throughout the experiment. The septic group (Group 2) received a 30-min infusion of E. coli. The treatment group (Group 3) received a continuous PGE1 infusion (100 ng/kg/min) along with the E. coli infusion which was begun 30 min after the PGE1 infusion was started. Control primates had hemodynamic changes consistent with the vasodilatory effect of PGE1 (heart rate and cardiac output increased; blood pressure and systemic vascular resistance (SVR) decreased). All control animals survived the experiment and had no evidence of pulmonary damage. Primates given E. coli developed severe hypotension, decreased SVR, and lung injury evidenced by pulmonary edema, decreased oxygenation, and increased extravascular lung water. Primates treated with both PGE1 and E. coli developed similar cardiovascular and pulmonary changes as the septic group. There was no statistically significant difference between Group 2 and Group 3 animals with regard to mean arterial blood pressure, SVR, extravascular lung water, alveolar-arterial oxygen difference, or survival.(ABSTRACT TRUNCATED AT 250 WORDS)