Aerosolized alpha-tocopherol ameliorates acute lung injury following combined burn and smoke inhalation injury in sheep

Naoki Morita, Maret G. Traber, Perenlei Enkhbaatar, Martin Westphal, Kazunori Murakami, Scott W. Leonard, Robert A. Cox, Hal K. Hawkins, David Herndon, Lillian D. Traber, Daniel L. Traber

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Victims of fire accidents who sustain both thermal injury to the skin and smoke inhalation have gross evidence of oxidant injury. Therefore, we hypothesized that delivery of vitamin E, an oxygen superoxide scavenger, directly into the airway would attenuate acute lung injury postburn and smoke inhalation. Sheep (N = 17 female, 35 ± 5 kg) were divided into 3 groups: (1) injured, then nebulized with vitamin E (B&S, Vitamin E, n = 6); (2) injured, nebulized with saline (B&S, Saline, n = 6); and (3) not injured, not treated (Sham, n = 5). While under deep anesthesia with isoflurane, the sheep were subjected to a flame burn (40% total body surface area, 3rd degree) and inhalation injury (48 breaths of cotton smoke, <40°C). All groups were resuscitated with Ringer lactate solution (4 mL/kg/%burn/24 h) and placed on a ventilator [positive end-expiratory pressure (PEEP) = 5 cm H2O, tidal volume = 15 mL/kg] for 48 h. B&S injury halved the lung alpha-tocopherol concentrations (0.9 ± 0.1 nmol/g) compared with sham-injured animals (1.5 ± 0.3), whereas vitamin E treatment elevated the lung alpha-tocopherol concentrations (7.40 ± 2.61) in the injured animals. B&S injury decreased pulmonary gas exchange (PaO 2/FiO2 ratios) from 517 ± 15 at baseline to 329 ± 49 at 24 h and to 149 ± 32 at 48 h compared with sham ratios of 477 ± 14, 536 ± 48, and 609 ± 49, respectively. Vitamin E treatment resulted in a significant improvement of pulmonary gas exchange; ratios were 415 ± 34 and 283 ± 42 at 24 and 48 h, respectively. Vitamin E nebulization therapy improved the clinical responses to burn and smoke inhalation-induced acute lung injury.

Original languageEnglish (US)
Pages (from-to)277-282
Number of pages6
JournalShock
Volume25
Issue number3
DOIs
StatePublished - Mar 2006

Fingerprint

Smoke Inhalation Injury
Acute Lung Injury
alpha-Tocopherol
Vitamin E
Sheep
Smoke
Inhalation
Pulmonary Gas Exchange
Wounds and Injuries
Inhalation Burns
Positive-Pressure Respiration
Body Surface Area
Isoflurane
Tidal Volume
Lung Injury
Mechanical Ventilators
Burns
Oxidants
Superoxides
Accidents

Keywords

  • 3-nitrotyrosine
  • Antioxidant
  • Gamma-tocopherol
  • Inhalation injury
  • Nebulization
  • Pulmonary
  • Reactive nitrogen species
  • Reactive oxygen species
  • Superoxide

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Physiology

Cite this

Aerosolized alpha-tocopherol ameliorates acute lung injury following combined burn and smoke inhalation injury in sheep. / Morita, Naoki; Traber, Maret G.; Enkhbaatar, Perenlei; Westphal, Martin; Murakami, Kazunori; Leonard, Scott W.; Cox, Robert A.; Hawkins, Hal K.; Herndon, David; Traber, Lillian D.; Traber, Daniel L.

In: Shock, Vol. 25, No. 3, 03.2006, p. 277-282.

Research output: Contribution to journalArticle

Morita, N, Traber, MG, Enkhbaatar, P, Westphal, M, Murakami, K, Leonard, SW, Cox, RA, Hawkins, HK, Herndon, D, Traber, LD & Traber, DL 2006, 'Aerosolized alpha-tocopherol ameliorates acute lung injury following combined burn and smoke inhalation injury in sheep', Shock, vol. 25, no. 3, pp. 277-282. https://doi.org/10.1097/01.shk.0000208805.23182.a7
Morita, Naoki ; Traber, Maret G. ; Enkhbaatar, Perenlei ; Westphal, Martin ; Murakami, Kazunori ; Leonard, Scott W. ; Cox, Robert A. ; Hawkins, Hal K. ; Herndon, David ; Traber, Lillian D. ; Traber, Daniel L. / Aerosolized alpha-tocopherol ameliorates acute lung injury following combined burn and smoke inhalation injury in sheep. In: Shock. 2006 ; Vol. 25, No. 3. pp. 277-282.
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abstract = "Victims of fire accidents who sustain both thermal injury to the skin and smoke inhalation have gross evidence of oxidant injury. Therefore, we hypothesized that delivery of vitamin E, an oxygen superoxide scavenger, directly into the airway would attenuate acute lung injury postburn and smoke inhalation. Sheep (N = 17 female, 35 ± 5 kg) were divided into 3 groups: (1) injured, then nebulized with vitamin E (B&S, Vitamin E, n = 6); (2) injured, nebulized with saline (B&S, Saline, n = 6); and (3) not injured, not treated (Sham, n = 5). While under deep anesthesia with isoflurane, the sheep were subjected to a flame burn (40{\%} total body surface area, 3rd degree) and inhalation injury (48 breaths of cotton smoke, <40°C). All groups were resuscitated with Ringer lactate solution (4 mL/kg/{\%}burn/24 h) and placed on a ventilator [positive end-expiratory pressure (PEEP) = 5 cm H2O, tidal volume = 15 mL/kg] for 48 h. B&S injury halved the lung alpha-tocopherol concentrations (0.9 ± 0.1 nmol/g) compared with sham-injured animals (1.5 ± 0.3), whereas vitamin E treatment elevated the lung alpha-tocopherol concentrations (7.40 ± 2.61) in the injured animals. B&S injury decreased pulmonary gas exchange (PaO 2/FiO2 ratios) from 517 ± 15 at baseline to 329 ± 49 at 24 h and to 149 ± 32 at 48 h compared with sham ratios of 477 ± 14, 536 ± 48, and 609 ± 49, respectively. Vitamin E treatment resulted in a significant improvement of pulmonary gas exchange; ratios were 415 ± 34 and 283 ± 42 at 24 and 48 h, respectively. Vitamin E nebulization therapy improved the clinical responses to burn and smoke inhalation-induced acute lung injury.",
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