Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep

Kazunori Murakami, Roy McGuire, Robert A. Cox, Jeffrey M. Jodoin, Lars J. Bjertnaes, Jiro Katahira, Lillian D. Traber, Frank C. Schmalstieg, Hal K. Hawkins, David Herndon, Daniel L. Traber

Research output: Contribution to journalArticle

141 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)236-241
Number of pages6
JournalShock
Volume18
Issue number3
StatePublished - Sep 2002

Fingerprint

Acute Lung Injury
Smoke
Inhalation
Heparin
Sheep
Sepsis
Lung
Wounds and Injuries
Smoke Inhalation Injury
Tracheotomy
Lung Injury
Pseudomonas
Artificial Respiration
Pseudomonas aeruginosa
Edema
Pneumonia

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

Murakami, K., McGuire, R., Cox, R. A., Jodoin, J. M., Bjertnaes, L. J., Katahira, J., ... Traber, D. L. (2002). Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep. Shock, 18(3), 236-241.

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 journalArticle

Murakami, K, McGuire, R, Cox, RA, Jodoin, JM, Bjertnaes, LJ, Katahira, J, Traber, LD, Schmalstieg, FC, Hawkins, HK, Herndon, D & Traber, DL 2002, 'Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep', Shock, vol. 18, no. 3, pp. 236-241.
Murakami K, McGuire R, Cox RA, Jodoin JM, Bjertnaes LJ, Katahira J et al. Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep. Shock. 2002 Sep;18(3):236-241.
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. / Heparin nebulization attenuates acute lung injury in sepsis following smoke inhalation in sheep. In: Shock. 2002 ; Vol. 18, No. 3. pp. 236-241.
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