Aerosolized tissue plasminogen inhibitor improves pulmonary function in sheep with burn and smoke inhalation

Perenlei Enkhbaatar, Kazunori Murakami, Robert Cox, Martin Westphal, Naoki Morita, Kimberly Brantley, Ann Burke, Hal Hawkins, Frank Schmalstieg, Lillian Traber, David Herndon, Daniel Traber

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Acute respiratory distress syndrome is a major complication in patients with thermal injury. The obstruction of the airway by cast material, composed in part of fibrin, contributes to deterioration of pulmonary gas exchange. We tested the effect of aerosol administration of tissue plasminogen activator, which lyses fibrin clots, on acute lung injury in sheep that had undergone combined burn/smoke inhalation injury. Anesthetized sheep were given a 40% total body surface, third degree burn and were insufflated with cotton smoke. Tissue plasminogen activator (TPA) was nebulized every 4 h at 1 or 2 mg for each nebulization, beginning 4 h after injury. Injured but untreated control sheep developed multiple symptoms of acute respiratory distress syndrome: decreased pulmonary gas exchange, increased pulmonary edema, and extensive airway obstruction. These control animals also showed increased pulmonary transvascular fluid flux and increased airway pressures. These variables were all stable in sham animals. Nebulization of saline or 1 mg of TPA only slightly improved measures of pulmonary function. Treatment of injured sheep with 2 mg of TPA attenuated all the pulmonary abnormalities noted above. The results provide evidence that clearance of airway obstructive cast material is crucial in managing acute respiratory distress syndrome resulting from combined burn and smoke inhalation injury.

Original languageEnglish (US)
Pages (from-to)70-75
Number of pages6
JournalShock
Volume22
Issue number1
DOIs
StatePublished - Jul 2004

Fingerprint

Inhalation Burns
Plasminogen
Tissue Plasminogen Activator
Smoke
Sheep
Adult Respiratory Distress Syndrome
Smoke Inhalation Injury
Pulmonary Gas Exchange
Lung
Airway Obstruction
Fibrin
Acute Lung Injury
Wounds and Injuries
Pulmonary Edema
Aerosols
Burns
Hot Temperature
Pressure

Keywords

  • Airway obstruction
  • ARDS
  • Lung

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Physiology

Cite this

Aerosolized tissue plasminogen inhibitor improves pulmonary function in sheep with burn and smoke inhalation. / Enkhbaatar, Perenlei; Murakami, Kazunori; Cox, Robert; Westphal, Martin; Morita, Naoki; Brantley, Kimberly; Burke, Ann; Hawkins, Hal; Schmalstieg, Frank; Traber, Lillian; Herndon, David; Traber, Daniel.

In: Shock, Vol. 22, No. 1, 07.2004, p. 70-75.

Research output: Contribution to journalArticle

Enkhbaatar, P, Murakami, K, Cox, R, Westphal, M, Morita, N, Brantley, K, Burke, A, Hawkins, H, Schmalstieg, F, Traber, L, Herndon, D & Traber, D 2004, 'Aerosolized tissue plasminogen inhibitor improves pulmonary function in sheep with burn and smoke inhalation', Shock, vol. 22, no. 1, pp. 70-75. https://doi.org/10.1097/01.shk.0000129201.38588.85
Enkhbaatar, Perenlei ; Murakami, Kazunori ; Cox, Robert ; Westphal, Martin ; Morita, Naoki ; Brantley, Kimberly ; Burke, Ann ; Hawkins, Hal ; Schmalstieg, Frank ; Traber, Lillian ; Herndon, David ; Traber, Daniel. / Aerosolized tissue plasminogen inhibitor improves pulmonary function in sheep with burn and smoke inhalation. In: Shock. 2004 ; Vol. 22, No. 1. pp. 70-75.
@article{8da6ad0b467040fca8509d154fe37a0e,
title = "Aerosolized tissue plasminogen inhibitor improves pulmonary function in sheep with burn and smoke inhalation",
abstract = "Acute respiratory distress syndrome is a major complication in patients with thermal injury. The obstruction of the airway by cast material, composed in part of fibrin, contributes to deterioration of pulmonary gas exchange. We tested the effect of aerosol administration of tissue plasminogen activator, which lyses fibrin clots, on acute lung injury in sheep that had undergone combined burn/smoke inhalation injury. Anesthetized sheep were given a 40{\%} total body surface, third degree burn and were insufflated with cotton smoke. Tissue plasminogen activator (TPA) was nebulized every 4 h at 1 or 2 mg for each nebulization, beginning 4 h after injury. Injured but untreated control sheep developed multiple symptoms of acute respiratory distress syndrome: decreased pulmonary gas exchange, increased pulmonary edema, and extensive airway obstruction. These control animals also showed increased pulmonary transvascular fluid flux and increased airway pressures. These variables were all stable in sham animals. Nebulization of saline or 1 mg of TPA only slightly improved measures of pulmonary function. Treatment of injured sheep with 2 mg of TPA attenuated all the pulmonary abnormalities noted above. The results provide evidence that clearance of airway obstructive cast material is crucial in managing acute respiratory distress syndrome resulting from combined burn and smoke inhalation injury.",
keywords = "Airway obstruction, ARDS, Lung",
author = "Perenlei Enkhbaatar and Kazunori Murakami and Robert Cox and Martin Westphal and Naoki Morita and Kimberly Brantley and Ann Burke and Hal Hawkins and Frank Schmalstieg and Lillian Traber and David Herndon and Daniel Traber",
year = "2004",
month = "7",
doi = "10.1097/01.shk.0000129201.38588.85",
language = "English (US)",
volume = "22",
pages = "70--75",
journal = "Shock",
issn = "1073-2322",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Aerosolized tissue plasminogen inhibitor improves pulmonary function in sheep with burn and smoke inhalation

AU - Enkhbaatar, Perenlei

AU - Murakami, Kazunori

AU - Cox, Robert

AU - Westphal, Martin

AU - Morita, Naoki

AU - Brantley, Kimberly

AU - Burke, Ann

AU - Hawkins, Hal

AU - Schmalstieg, Frank

AU - Traber, Lillian

AU - Herndon, David

AU - Traber, Daniel

PY - 2004/7

Y1 - 2004/7

N2 - Acute respiratory distress syndrome is a major complication in patients with thermal injury. The obstruction of the airway by cast material, composed in part of fibrin, contributes to deterioration of pulmonary gas exchange. We tested the effect of aerosol administration of tissue plasminogen activator, which lyses fibrin clots, on acute lung injury in sheep that had undergone combined burn/smoke inhalation injury. Anesthetized sheep were given a 40% total body surface, third degree burn and were insufflated with cotton smoke. Tissue plasminogen activator (TPA) was nebulized every 4 h at 1 or 2 mg for each nebulization, beginning 4 h after injury. Injured but untreated control sheep developed multiple symptoms of acute respiratory distress syndrome: decreased pulmonary gas exchange, increased pulmonary edema, and extensive airway obstruction. These control animals also showed increased pulmonary transvascular fluid flux and increased airway pressures. These variables were all stable in sham animals. Nebulization of saline or 1 mg of TPA only slightly improved measures of pulmonary function. Treatment of injured sheep with 2 mg of TPA attenuated all the pulmonary abnormalities noted above. The results provide evidence that clearance of airway obstructive cast material is crucial in managing acute respiratory distress syndrome resulting from combined burn and smoke inhalation injury.

AB - Acute respiratory distress syndrome is a major complication in patients with thermal injury. The obstruction of the airway by cast material, composed in part of fibrin, contributes to deterioration of pulmonary gas exchange. We tested the effect of aerosol administration of tissue plasminogen activator, which lyses fibrin clots, on acute lung injury in sheep that had undergone combined burn/smoke inhalation injury. Anesthetized sheep were given a 40% total body surface, third degree burn and were insufflated with cotton smoke. Tissue plasminogen activator (TPA) was nebulized every 4 h at 1 or 2 mg for each nebulization, beginning 4 h after injury. Injured but untreated control sheep developed multiple symptoms of acute respiratory distress syndrome: decreased pulmonary gas exchange, increased pulmonary edema, and extensive airway obstruction. These control animals also showed increased pulmonary transvascular fluid flux and increased airway pressures. These variables were all stable in sham animals. Nebulization of saline or 1 mg of TPA only slightly improved measures of pulmonary function. Treatment of injured sheep with 2 mg of TPA attenuated all the pulmonary abnormalities noted above. The results provide evidence that clearance of airway obstructive cast material is crucial in managing acute respiratory distress syndrome resulting from combined burn and smoke inhalation injury.

KW - Airway obstruction

KW - ARDS

KW - Lung

UR - http://www.scopus.com/inward/record.url?scp=13644251630&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=13644251630&partnerID=8YFLogxK

U2 - 10.1097/01.shk.0000129201.38588.85

DO - 10.1097/01.shk.0000129201.38588.85

M3 - Article

VL - 22

SP - 70

EP - 75

JO - Shock

JF - Shock

SN - 1073-2322

IS - 1

ER -