Abstract
Pseudomonas pneumonia is a common complication of smoke inhalation injury. Airway casts formed from clotted mucous occur frequently in this condition. A recent report shows that intravenous heparin improves oxygenation and reduces lung damage in a sheep model of smoke inhalation. We hypothesized that nebulized heparin could be an effective means of reducing cast formation. Female sheep (n = 19) were surgically prepared for a study of acute lung injury (ALI). After a tracheotomy, 48 breaths of cotton smoke (<40°C) were inflated into the airway. Afterwards, live Pseudomonas aeruginosa (5 x 1011 CFU) was instilled into the lung. All sheep were mechanically ventilated with 100% O2 and were divided into four groups: a heparin-nebulized group (n = 5; animals received aerosolized heparin [10,000 I.U.] 1 h after the bacterial instillation and subsequently every 4 h thereafter), an intravenous heparin group (n = 5,300U/kg/23 h, infusion was started 1 h after the injury), a saline-nebulization group (n = 5; animals received inhaled nebulized saline), and a sham injury group (n = 4, treated in the same fashion, but no injury). The animals were sacrificed after 24 h of mechanical ventilation, and lung samples were harvested. Sheep exposed to lung injury presented with typical hyperdynamic cardiovascular changes and a corresponding drop in PaO2. These changes were significantly attenuated in the heparin groups. Histological changes consisting of cellular infiltrates, lung edema, congestion, and cast formation were reduced by heparin. These data suggest that nebulized inhaled heparin is a beneficial therapy for sepsis-induced ALI.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 236-241 |
| Number of pages | 6 |
| Journal | Shock |
| Volume | 18 |
| Issue number | 3 |
| State | Published - Sep 2002 |
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Keywords
- Acute respiratory distress syndrome
- Airway cast
- Histology score
- Pneumonia
- Sepsis
- Shunt
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
- Physiology
Cite this
Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep. / Murakami, Kazunori; McGuire, Roy; Cox, Robert A.; Jodoin, Jeffrey M.; Bjertnaes, Lars J.; Katahira, Jiro; Traber, Lillian D.; Schmalstieg, Frank C.; Hawkins, Hal K.; Herndon, David; Traber, Daniel L.
In: Shock, Vol. 18, No. 3, 09.2002, p. 236-241.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep
AU - Murakami, Kazunori
AU - McGuire, Roy
AU - Cox, Robert A.
AU - Jodoin, Jeffrey M.
AU - Bjertnaes, Lars J.
AU - Katahira, Jiro
AU - Traber, Lillian D.
AU - Schmalstieg, Frank C.
AU - Hawkins, Hal K.
AU - Herndon, David
AU - Traber, Daniel L.
PY - 2002/9
Y1 - 2002/9
N2 - Pseudomonas pneumonia is a common complication of smoke inhalation injury. Airway casts formed from clotted mucous occur frequently in this condition. A recent report shows that intravenous heparin improves oxygenation and reduces lung damage in a sheep model of smoke inhalation. We hypothesized that nebulized heparin could be an effective means of reducing cast formation. Female sheep (n = 19) were surgically prepared for a study of acute lung injury (ALI). After a tracheotomy, 48 breaths of cotton smoke (<40°C) were inflated into the airway. Afterwards, live Pseudomonas aeruginosa (5 x 1011 CFU) was instilled into the lung. All sheep were mechanically ventilated with 100% O2 and were divided into four groups: a heparin-nebulized group (n = 5; animals received aerosolized heparin [10,000 I.U.] 1 h after the bacterial instillation and subsequently every 4 h thereafter), an intravenous heparin group (n = 5,300U/kg/23 h, infusion was started 1 h after the injury), a saline-nebulization group (n = 5; animals received inhaled nebulized saline), and a sham injury group (n = 4, treated in the same fashion, but no injury). The animals were sacrificed after 24 h of mechanical ventilation, and lung samples were harvested. Sheep exposed to lung injury presented with typical hyperdynamic cardiovascular changes and a corresponding drop in PaO2. These changes were significantly attenuated in the heparin groups. Histological changes consisting of cellular infiltrates, lung edema, congestion, and cast formation were reduced by heparin. These data suggest that nebulized inhaled heparin is a beneficial therapy for sepsis-induced ALI.
AB - Pseudomonas pneumonia is a common complication of smoke inhalation injury. Airway casts formed from clotted mucous occur frequently in this condition. A recent report shows that intravenous heparin improves oxygenation and reduces lung damage in a sheep model of smoke inhalation. We hypothesized that nebulized heparin could be an effective means of reducing cast formation. Female sheep (n = 19) were surgically prepared for a study of acute lung injury (ALI). After a tracheotomy, 48 breaths of cotton smoke (<40°C) were inflated into the airway. Afterwards, live Pseudomonas aeruginosa (5 x 1011 CFU) was instilled into the lung. All sheep were mechanically ventilated with 100% O2 and were divided into four groups: a heparin-nebulized group (n = 5; animals received aerosolized heparin [10,000 I.U.] 1 h after the bacterial instillation and subsequently every 4 h thereafter), an intravenous heparin group (n = 5,300U/kg/23 h, infusion was started 1 h after the injury), a saline-nebulization group (n = 5; animals received inhaled nebulized saline), and a sham injury group (n = 4, treated in the same fashion, but no injury). The animals were sacrificed after 24 h of mechanical ventilation, and lung samples were harvested. Sheep exposed to lung injury presented with typical hyperdynamic cardiovascular changes and a corresponding drop in PaO2. These changes were significantly attenuated in the heparin groups. Histological changes consisting of cellular infiltrates, lung edema, congestion, and cast formation were reduced by heparin. These data suggest that nebulized inhaled heparin is a beneficial therapy for sepsis-induced ALI.
KW - Acute respiratory distress syndrome
KW - Airway cast
KW - Histology score
KW - Pneumonia
KW - Sepsis
KW - Shunt
UR - http://www.scopus.com/inward/record.url?scp=6444244640&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=6444244640&partnerID=8YFLogxK
M3 - Article
C2 - 12353924
AN - SCOPUS:6444244640
VL - 18
SP - 236
EP - 241
JO - Shock
JF - Shock
SN - 1073-2322
IS - 3
ER -