Evaluation of different treatment protocols for combined injury-induced lung injury in rabbits

BACKGROUND: This study aims to evaluate the effectiveness of different treatment regimens on combined injury-induced lung injury.
METHODS: Rabbits were subjected to non-lethal closed-chest bilateral lung contusion followed by a 30% total body surface area scald burn. The rabbits were randomly assigned to resuscitation groups that maintained a minimum mean arterial blood pressure of 70 mmHg using one of the following three methods: normal saline plus polygeline injection in a ratio of 1: 1 (1: 1G), normal saline plus polygeline injection in a ratio of 1: 2 (1: 2G), and normal saline plus polygeline injection in a ratio of 1: 3 (1: 3G), After injury, lung injury was assessed using lung wet-to-dry (W/D) weight ratio, enzyme-linked immunosorbent assay, and real-time PCR.
RESULTS: In the 1: 3 fluid resuscitation group, rabbits exhibited significantly reduced lung W/D ratio, alveolar hemorrhage, myeloperoxidase activity, and IL-8 and TNF-α levels in the serum compared with the 1: 1 or 1: 2 fluid resuscitation groups. The 1: 3 fluid resuscitation-treated rabbits also attenuated ultrastructural changes in the lung 24 h after the combined injury.
CONCLUSION: This study demonstrated the impact of fluid resuscitation on combined injury-induced lung injury. Further, 1: 3 fluid resuscitation treatment at the early stage of lung injury after combined lung contusion and burn injury was found to be more effective.

Tavþanlarda kombine travmanýn neden olduðu akciðer yaralanmasýnda farklý tedavi protokollerinin deðerlendirilmesi

AMAÇ: Kombine travmanýn neden olduðu akciðer yaralanmasýnda farklý tedavi rejimlerinin etkinliðini deðerlendirmeyi amaçlamaktadýr.
GEREÇ VE YÖNTEM: Tavþanlar ölümcül olmayan iki taraflý kapalý göðüs kontüzyonu ardýndan tüm vücut alanýnýn %30’unu tutan haþlanma yanýðýna maruz býrakýldý. Tavþanlar minimum ortalama arter kan basýncý 70 mmHg’nin üç yöntemle baþka bir deyiþle 1: 1, 1: 2 veya 1: 3 oranýnda normal salin/poligelin enjeksiyonlarý ile idame ettirilen resüsitasyon gruplarýndan birine randomize edildi (sýrasýyla, 1: 1G, 1: 2 G ve 1: 3 G). Travmadan sonra akciðer yaralanmasý ýslak/kuru (I/K) akciðer aðýrlýðý oraný, ELISA ve gerçek zamanlý PCR analiziyle deðerlendirildi.
BULGULAR: 1: 1 veya 1: 2 sývý resüsitasyon grubuna göre 1: 3 sývý resüsitasyon grubunda tavþanlarda azalmýþ akciðer I/K oraný, alveoler kanama, MPO aktivitesi ve serumda düþük IL-8 ve TNF-α düzeyleri saptandý. Ayrýca 1: 3 sývý resüsitasyonu uygulanan tavþanlarda kombine yaralanmadan 24 saat sonra ultrastrüktürel deðiþiklikler de azaldý.
TARTIÞMA: Bu çalýþma kombine yaralanmaya maruz kalan akciðerde sývý resüsitasyonunun etkisini göstermiþtir. Akciðer yaralanmasýnýn erken evresinde kombine akciðer kontüzyonu ve yanýk yaralanmasýndan sonra 1: 3 sývý resüsitasyonuyla tedavi daha efektiftir.