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Severe Polytrauma Leads to Acute Lung Injury in Rats
Author(s) -
Wu Xiaowu,
Schwacha Martin,
Dubick Michael,
Cap Andrew,
Darlington Daniel
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.641.8
Subject(s) - medicine , resuscitation , polytrauma , lung , anesthesia , myeloperoxidase , sepsis , inflammation , surgery
Background Trauma, hemorrhage and fluid resuscitation can lead to the development of acute lung injury (ALI). However, it is not known if ALI develops in the pre‐hospital setting, before resuscitative care is given. Method: Polytrauma was induced in anesthetized Sprague‐Dawley rats (n=8) by damage to the small intestines, liver, leg skeletal muscle and femur fracture. Rats were than bled to a MAP of 40mmHg until 40% of the blood volume was removed. Fluid resuscitation was given at one hour. Rats were euthanized at 0, 2 and 4hrs, and lung and liver tissue collected. Results: In lung tissue, polytrauma with hemorrhage led to an infiltration of neutrophils, monocyte/macrophage, and platelet aggregates, and a significant elevation in myeloperoxidase, pro‐inflammatory cytokines (IL‐6, IL‐1α, IL‐1β), chemokines (MIP‐1α and GRO KC) and anti‐inflammatory cytokines IL‐4, IL‐10 and IL‐13. Resuscitation with Lactated Ringer's as well as Fresh Whole Blood led to elevation in the lung wet/dry weight ratios that did not occur with no resuscitation. Conclusion Polytrauma with hemorrhage led to fluid movement into the lungs only after resuscitation with crystalloid or whole blood. The infiltration of neutrophils, monocytes and platelets and the elevation in myeloperoxidase and pro‐inflammatory cytokines likely damaged the lung barrier membrane prior to resuscitation, priming the tissue for leakage once resuscitation was initiated. This project was funded by MRMC.