Integrity of airway epithelium in pediatric burn autopsies: Association with age and extent of burn injury

Robert A. Cox, Sam Jacob, Clark R. Andersen, Ron Mlcak, Linda Sousse, Yong Zhu, Christopher Cotto, Celeste Finnerty, Perenlei Enkhbaatar, David Herndon, Hal K. Hawkins

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

This study examines the structural integrity of the airway epithelium in autopsy tissues from pediatric burn subjects. Methods A semi-quantitative score for the degree of airway epithelial integrity was made for seventy- two pediatric burn autopsies. Multivariate ordinal logistic regression was performed to identify relationships between epithelial integrity and conditions related to tissue fixation, time of death after injury, age, total body surface area burn (TBSA), extent of 3rd degree burn, presence of inhalation injury, ventilator days and pneumonia. Results No significant difference in epithelial integrity scores was identified between burn only cases and those with inhalation injury. Significant correlations with bronchiolar epithelial integrity scores were identified for age, p = 0.02, and percent 3rd degree burn, p = 0.02. There was no significant relationship between epithelial integrity and time between death and autopsy, p > 0.44. Conclusions Airway epithelial loss seen in autopsy tissue is not simply an artifact of tissue fixation. The degree of compromise correlates most strongly with age and degree of burn. Further studies are needed to identify physiological or critical care factors following burn injury that contribute to compromise in the structural and functional properties of the airway epithelium.

Original languageEnglish (US)
Pages (from-to)1435-1441
Number of pages7
JournalBurns
Volume41
Issue number7
DOIs
StatePublished - Nov 1 2015

Keywords

  • Infection
  • Innate defense
  • Mucociliary function
  • Pneumonia
  • Trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine
  • Surgery

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    Cox, R. A., Jacob, S., Andersen, C. R., Mlcak, R., Sousse, L., Zhu, Y., Cotto, C., Finnerty, C., Enkhbaatar, P., Herndon, D., & Hawkins, H. K. (2015). Integrity of airway epithelium in pediatric burn autopsies: Association with age and extent of burn injury. Burns, 41(7), 1435-1441. https://doi.org/10.1016/j.burns.2015.05.003