Artikel
Significant development of lung injury and the corresponding biomarker increase in a new long-term porcine model for mono- and polytrauma
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Autoren
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Birgit Auner
- Department of Trauma, Hand and Reconstructive Surgery , University Hospital Frankfurt, Goethe-University, Frankfurt, Germany
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Philipp Stoermann
- Department of Trauma, Hand and Reconstructive Surgery , University Hospital Frankfurt, Goethe-University, Frankfurt, Germany
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Klemens Horst
- Department of Orthopaedic Trauma, Harald Tscherne Research Laboratory, RWTH Aachen University, Aachen, Germany
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Borna Relja
- Department of Trauma, Hand and Reconstructive Surgery , University Hospital Frankfurt, Goethe-University, Frankfurt, Germany
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Ingo Marzi
- Department of Trauma, Hand and Reconstructive Surgery , University Hospital Frankfurt, Goethe-University, Frankfurt, Germany
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TREAT Research Group
| Veröffentlicht: | 10. Oktober 2016 |
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Gliederung
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Objectives: In a newly established long-term porcine trauma model remote organ damage after lung injury was compared after monotrauma and after polytrauma. The relevance of the pro-inflammatory lipid mediator Leukotriene B4 (LTB4), that correlates well with the acute phase of Acute Respiratory Distress Syndrome (ARDS) in trauma patients, to indicating lung integrity in this model, was evaluated.
Methods: Twelve male pigs (sus scrofa; 3 months, 30±5 Kg) underwent polytrauma (PT) including standardized femur fracture, unilateral lung contusion, liver laceration, hemorrhagic shock (40 mmHg, 90 mins), subsequent resuscitation and surgical fracture fixation. After setting femur fracture, six animals were included in the monotrauma group (MT). Six animals served as controls (sham). The observational/ventilation period was 72 hours, thereafter, lung tissue was removed for (immune)histological and gene expression analyses. Blood samples for LTB4 determination were collected before the experiment (0 h), immediately after trauma (a. tr.), 2, 4, 24 or 72 h after trauma. BAL-fluid was collected prior and after the experiment (0 and 72 h).
Results: Lung injury was markedly increased in MT but significantly increased in PT compared with sham (Lung Injury Score: MT vs. sham: 0.89±0.20 vs. 0.37±0.18; PT vs. sham: 1.45±0.13 vs. 0.37±0.18, p<0.05). Lung injury (of the contralateral side) was significantly increased in PT vs. MT. Local gene expression of IL-6 was significantly increased in PT vs. sham. Infiltration of lungs with neutrophils was significantly enhanced in MT vs. sham (1.57±0.22 vs. 0.98±0.08 cells/high power field, p<0.05), MT vs. PT (1.57±0.22 vs. 2.37±0.22, p<0.05) and PT vs. sham (p<0.05). Serum LTB4 concentration increased markedly in PT compared with sham (384.9±64.5 vs. 209.4±56.3 pg/mL, p=0.058) or MT (252.2±60.75 pg/mL) after 72 h. LTB4 levels in the BAL-fluid were significantly increased in PT (50.88±15.02 pg/mL) vs. sham (p<0.05), and strongly increased compared with MT (18.19±6.49 pg/mL, p=0.065).
Conclusion: Our data demonstrate 1. a clinically relevant monotrauma model that depicts remote secondary, indirect lung injury after femur fracture, 2. a clinically relevant polytrauma model showing lung injury to the contralateral side and inflammatory changes, and 3. a significant increase of LTB4 in this porcine long-term model, which is a clinically described biomarker for patients at risk for lung complications after polytrauma.
