A model of recovery from inhalation injury and cutaneous burn in ambulatory swine.

Autor: Burmeister DM; United States Army Institute of Surgical Research, United States., McIntyre MK; United States Army Institute of Surgical Research, United States., Beely B; United States Army Institute of Surgical Research, United States; The Geneva Foundation, Tacoma WA, United States., Jordan B; United States Army Institute of Surgical Research, United States., Walker KP 3rd; United States Army Institute of Surgical Research, United States., Aden JK; United States Army Institute of Surgical Research, United States., Batchinsky A; United States Army Institute of Surgical Research, United States; The Geneva Foundation, Tacoma WA, United States., Chung KK; United States Army Institute of Surgical Research, United States., Cancio LC; United States Army Institute of Surgical Research, United States., Christy RJ; United States Army Institute of Surgical Research, United States. Electronic address: robert.j.christy12.civ@mail.mil.
Jazyk: angličtina
Zdroj: Burns : journal of the International Society for Burn Injuries [Burns] 2017 Sep; Vol. 43 (6), pp. 1295-1305. Date of Electronic Publication: 2017 Apr 12.
DOI: 10.1016/j.burns.2017.03.010
Abstrakt: Inhalation injury commonly accompanies thermal injury, increasing the likelihood of mortality and multiple organ dysfunction (MOD). Large animal models have given important insight into the pathophysiology of this injury; however recapitulating late MOD has remained difficult. The current report describes experiments using a smoke inhalation and burn model, with follow-up of ambulatory swine for 14days with bronchoscopy, CT scanning, and bronchoalveolar lavage fluid (BALF)/blood collection. Clinically, animals cleared airway damage in the first several days after-injury. This was mirrored with erythematous airways on day 2 after-injury, which resolved by the end of the experiment, as did parenchymal damage seen on CT. An initial rise in the protein content of BALF immediately after-injury was followed by a dramatic increase in the concentration of leukocytes. Circulating neutrophils increased while lymphocytes decreased; both correlated with cell counts in BALF. IL8 levels in BALF increased 30-fold and remained elevated throughout the experiment. IL1ra increased circulation immediately after-injury, and afterwards in BALF. Other cytokines (TNFα, IL12) transiently increased in BALF (and decreased in circulation) on day 2. Taken together, these results display a remarkable capability for the lungs to recover in the absence of intubation, with further evidence of the role of cytokines such as IL8 and IL1ra. The possible exacerbating effects of clinical practices such as ventilation and bronchoscopies should be considered.
(Published by Elsevier Ltd.)
Databáze: MEDLINE
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