Assessment of combined muscarinic antagonist and fibrinolytic therapy for inhalation injury

Collette Jonkam, Yong Zhu, Sam Jacob, Sebastian Rehberg, Lillian D. Traber, David Herndon, Daniel L. Traber, Hal K. Hawkins, Perenlei Enkhbaatar, Robert A. Cox

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

This study tests the hypothesis that muscarinic receptor antagonist therapy with tiotropium bromide (tiotropium; TIO), alone or in combination with tissue plasminogen activator (TPA), can attenuate pulmonary dysfunction in sheep after smoke inhalation and burn injury. The study consisted of four study groups, sham (uninjured), control (injured and untreated), TIO (injured and treated with nebulized TIO), and TIO + TPA (injured and treated with nebulized TIO and TPA). Cardiopulmonary and ventilatory parameters were monitored for 48 hours. After killing the animal, airway obstruction, submucosal gland neutrophilia, parenchyma histopathology, and lung wet to dry weight ratios were measured. PaO2/FiO2 was significantly improved in the TIO group compared with the control group at 48 hours, 301 ± 149 vs 99 ± 33, respectively, P < .05. At 48 hours, peak airway pres- sures in the control, TIO, and TIO + TPA groups were 35 ± 6, 24 ± 7, and 26 ± 10, respectively, with the mean of the TIO group being significantly different from that of the control group, P < .05. A trend of decreased airway obstruction was seen in the treated animals compared with controls; however, the differences were not statistically significant. The TIO and TIO + TPA groups exhibited significant decreases in gland neutrophilia compared with the control group, P < .05. No differences in parenchyma histopathology and lung edema between injured control and treated groups were observed. Nebulization of TIO was effective in improving pulmonary performance and reducing bronchial submucosal gland neutrophilia in sheep after smoke inhalation and burn injury. There was no additive benefit to the inclusion of nebulized TPA with TIO. (J Burn Care Res 2012;33:524-531).

Original languageEnglish (US)
Pages (from-to)524-531
Number of pages8
JournalJournal of Burn Care and Research
Volume33
Issue number4
DOIs
StatePublished - Jul 2012

Fingerprint

Muscarinic Antagonists
Thrombolytic Therapy
Tissue Plasminogen Activator
Inhalation
Wounds and Injuries
Inhalation Burns
Smoke Inhalation Injury
Control Groups
Airway Obstruction
Lung
Sheep
Muscarinic Receptors
Pulmonary Edema
Edema
Pressure
Weights and Measures

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery

Cite this

Jonkam, C., Zhu, Y., Jacob, S., Rehberg, S., Traber, L. D., Herndon, D., ... Cox, R. A. (2012). Assessment of combined muscarinic antagonist and fibrinolytic therapy for inhalation injury. Journal of Burn Care and Research, 33(4), 524-531. https://doi.org/10.1097/BCR.0b013e31823dc7da

Assessment of combined muscarinic antagonist and fibrinolytic therapy for inhalation injury. / Jonkam, Collette; Zhu, Yong; Jacob, Sam; Rehberg, Sebastian; Traber, Lillian D.; Herndon, David; Traber, Daniel L.; Hawkins, Hal K.; Enkhbaatar, Perenlei; Cox, Robert A.

In: Journal of Burn Care and Research, Vol. 33, No. 4, 07.2012, p. 524-531.

Research output: Contribution to journalArticle

Jonkam, C, Zhu, Y, Jacob, S, Rehberg, S, Traber, LD, Herndon, D, Traber, DL, Hawkins, HK, Enkhbaatar, P & Cox, RA 2012, 'Assessment of combined muscarinic antagonist and fibrinolytic therapy for inhalation injury', Journal of Burn Care and Research, vol. 33, no. 4, pp. 524-531. https://doi.org/10.1097/BCR.0b013e31823dc7da
Jonkam, Collette ; Zhu, Yong ; Jacob, Sam ; Rehberg, Sebastian ; Traber, Lillian D. ; Herndon, David ; Traber, Daniel L. ; Hawkins, Hal K. ; Enkhbaatar, Perenlei ; Cox, Robert A. / Assessment of combined muscarinic antagonist and fibrinolytic therapy for inhalation injury. In: Journal of Burn Care and Research. 2012 ; Vol. 33, No. 4. pp. 524-531.
@article{5c41832292d743ab9121ad3c3c045701,
title = "Assessment of combined muscarinic antagonist and fibrinolytic therapy for inhalation injury",
abstract = "This study tests the hypothesis that muscarinic receptor antagonist therapy with tiotropium bromide (tiotropium; TIO), alone or in combination with tissue plasminogen activator (TPA), can attenuate pulmonary dysfunction in sheep after smoke inhalation and burn injury. The study consisted of four study groups, sham (uninjured), control (injured and untreated), TIO (injured and treated with nebulized TIO), and TIO + TPA (injured and treated with nebulized TIO and TPA). Cardiopulmonary and ventilatory parameters were monitored for 48 hours. After killing the animal, airway obstruction, submucosal gland neutrophilia, parenchyma histopathology, and lung wet to dry weight ratios were measured. PaO2/FiO2 was significantly improved in the TIO group compared with the control group at 48 hours, 301 ± 149 vs 99 ± 33, respectively, P < .05. At 48 hours, peak airway pres- sures in the control, TIO, and TIO + TPA groups were 35 ± 6, 24 ± 7, and 26 ± 10, respectively, with the mean of the TIO group being significantly different from that of the control group, P < .05. A trend of decreased airway obstruction was seen in the treated animals compared with controls; however, the differences were not statistically significant. The TIO and TIO + TPA groups exhibited significant decreases in gland neutrophilia compared with the control group, P < .05. No differences in parenchyma histopathology and lung edema between injured control and treated groups were observed. Nebulization of TIO was effective in improving pulmonary performance and reducing bronchial submucosal gland neutrophilia in sheep after smoke inhalation and burn injury. There was no additive benefit to the inclusion of nebulized TPA with TIO. (J Burn Care Res 2012;33:524-531).",
author = "Collette Jonkam and Yong Zhu and Sam Jacob and Sebastian Rehberg and Traber, {Lillian D.} and David Herndon and Traber, {Daniel L.} and Hawkins, {Hal K.} and Perenlei Enkhbaatar and Cox, {Robert A.}",
year = "2012",
month = "7",
doi = "10.1097/BCR.0b013e31823dc7da",
language = "English (US)",
volume = "33",
pages = "524--531",
journal = "Journal of Burn Care and Research",
issn = "1559-047X",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Assessment of combined muscarinic antagonist and fibrinolytic therapy for inhalation injury

AU - Jonkam, Collette

AU - Zhu, Yong

AU - Jacob, Sam

AU - Rehberg, Sebastian

AU - Traber, Lillian D.

AU - Herndon, David

AU - Traber, Daniel L.

AU - Hawkins, Hal K.

AU - Enkhbaatar, Perenlei

AU - Cox, Robert A.

PY - 2012/7

Y1 - 2012/7

N2 - This study tests the hypothesis that muscarinic receptor antagonist therapy with tiotropium bromide (tiotropium; TIO), alone or in combination with tissue plasminogen activator (TPA), can attenuate pulmonary dysfunction in sheep after smoke inhalation and burn injury. The study consisted of four study groups, sham (uninjured), control (injured and untreated), TIO (injured and treated with nebulized TIO), and TIO + TPA (injured and treated with nebulized TIO and TPA). Cardiopulmonary and ventilatory parameters were monitored for 48 hours. After killing the animal, airway obstruction, submucosal gland neutrophilia, parenchyma histopathology, and lung wet to dry weight ratios were measured. PaO2/FiO2 was significantly improved in the TIO group compared with the control group at 48 hours, 301 ± 149 vs 99 ± 33, respectively, P < .05. At 48 hours, peak airway pres- sures in the control, TIO, and TIO + TPA groups were 35 ± 6, 24 ± 7, and 26 ± 10, respectively, with the mean of the TIO group being significantly different from that of the control group, P < .05. A trend of decreased airway obstruction was seen in the treated animals compared with controls; however, the differences were not statistically significant. The TIO and TIO + TPA groups exhibited significant decreases in gland neutrophilia compared with the control group, P < .05. No differences in parenchyma histopathology and lung edema between injured control and treated groups were observed. Nebulization of TIO was effective in improving pulmonary performance and reducing bronchial submucosal gland neutrophilia in sheep after smoke inhalation and burn injury. There was no additive benefit to the inclusion of nebulized TPA with TIO. (J Burn Care Res 2012;33:524-531).

AB - This study tests the hypothesis that muscarinic receptor antagonist therapy with tiotropium bromide (tiotropium; TIO), alone or in combination with tissue plasminogen activator (TPA), can attenuate pulmonary dysfunction in sheep after smoke inhalation and burn injury. The study consisted of four study groups, sham (uninjured), control (injured and untreated), TIO (injured and treated with nebulized TIO), and TIO + TPA (injured and treated with nebulized TIO and TPA). Cardiopulmonary and ventilatory parameters were monitored for 48 hours. After killing the animal, airway obstruction, submucosal gland neutrophilia, parenchyma histopathology, and lung wet to dry weight ratios were measured. PaO2/FiO2 was significantly improved in the TIO group compared with the control group at 48 hours, 301 ± 149 vs 99 ± 33, respectively, P < .05. At 48 hours, peak airway pres- sures in the control, TIO, and TIO + TPA groups were 35 ± 6, 24 ± 7, and 26 ± 10, respectively, with the mean of the TIO group being significantly different from that of the control group, P < .05. A trend of decreased airway obstruction was seen in the treated animals compared with controls; however, the differences were not statistically significant. The TIO and TIO + TPA groups exhibited significant decreases in gland neutrophilia compared with the control group, P < .05. No differences in parenchyma histopathology and lung edema between injured control and treated groups were observed. Nebulization of TIO was effective in improving pulmonary performance and reducing bronchial submucosal gland neutrophilia in sheep after smoke inhalation and burn injury. There was no additive benefit to the inclusion of nebulized TPA with TIO. (J Burn Care Res 2012;33:524-531).

UR - http://www.scopus.com/inward/record.url?scp=84866055534&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84866055534&partnerID=8YFLogxK

U2 - 10.1097/BCR.0b013e31823dc7da

DO - 10.1097/BCR.0b013e31823dc7da

M3 - Article

C2 - 22210073

AN - SCOPUS:84866055534

VL - 33

SP - 524

EP - 531

JO - Journal of Burn Care and Research

JF - Journal of Burn Care and Research

SN - 1559-047X

IS - 4

ER -