Airway obstruction in sheep with burn and smoke inhalation injuries

被引:111
作者
Cox, RA
Burke, AS
Soejima, K
Murakami, K
Katahira, J
Traber, DL
Hawkins, HK
机构
[1] Shriners Hosp Children, Galveston, TX 77550 USA
[2] Univ Texas, Med Branch, Dept Anesthesiol, Galveston, TX 77550 USA
[3] Univ Texas, Med Branch, Dept Pediat, Galveston, TX 77550 USA
[4] Univ Texas, Med Branch, Dept Pathol, Galveston, TX 77550 USA
[5] Univ Texas, Med Branch, Dept Surg, Galveston, TX 77550 USA
关键词
BRONCHIAL CASTS; OVINE MODEL; LUNG INJURY; INTERLEUKIN-8; EXPRESSION; EPITHELIUM; INDUCTION; CHILDREN; PHASE;
D O I
10.1165/rcmb.4860
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
The goals of this study were (i) to compare the degree and (ii) temporal changes in airway obstruction in sheep with pulmonary injury induced by smoke inhalation and/or burn; (W) to qualitatively assess the cellular and mucous content of obstructive material; and (iv) to statistically assess a possible relationship between the degree of airway obstruction and pulmonary dysfunction. Using masked histologic slides, we estimated the degree of luminal obstruction in all cross-sectioned airways. The mean degree of bronchial, bronchiolar, and terminal bronchiolar obstruction was significantly greater in animals with smoke injury alone or combined smoke inhalation and burn (S+B) injury, compared with animals with burn injury alone or uninjured animals (P < 0.05). In S+B animals, the degree of bronchial obstruction was maximal at 24 h, with a progressive decrease over 72 h. In contrast, the degree of bronchiolar obstruction increased over time. Qualitatively, bronchial casts were largely composed of mucus at early times after injury, whereas neutrophils were the principal component of bronchiolar obstructive material. Localization of specific mucin subtypes in S+B tissues suggests that increasing bronchiolar obstruction is derived, in part, from upper airway material. Multiple linear regression analysis of airway obstruction scores compared with Pa-O2/Fl(O2) values showed a correlation coefficient of r = 0.76, with bronchial and bronchiolar scores predictive of Pa-O2 /Fl(O2), (P < 0.05). These results suggest that strategies to remove or decrease formation of upper airway obstructive material may reduce its deposition into small airways and parenchyma and may improve respiratory function in victims of smoke inhalation injury.
引用
收藏
页码:295 / 302
页数:8
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