New clinically relevant sheep model of severe respiratory failure secondary to combined smoke inhalation/cutaneous flame injury

Scott K. Alpard, Joseph B. Zwischenberger, Weike Tao, Donald J. Deyo, Daniel L. Traber, Akhil Bidani

    Research output: Contribution to journalArticle

    54 Citations (Scopus)

    Abstract

    Objectives: To develop a predictable, dose-dependent, clinically relevant model of severe respiratory failure associated with a 40% total body surface area, full-thickness (third-degree) cutaneous flame burn and smoke inhalation injury in adult sheep. Design: Model development. Setting: Research laboratory. Subjects: Adult female sheep (n = 22). Interventions: Animals were divided into three groups, determined by the number of smoke breaths administered (24, 36, 48) for a graded inhalation injury. The smoke was insufflated into a tracheostomy with a modified bee smoker at airway temperatures <40°C. All animals concurrently received a 40% total body surface area (third-degree) cutaneous flame burn to the body (flanks). After injury, the animals were placed on volume-controlled ventilation to achieve PaO2 >60 mm Hg and PaCO2 <40 mm Hg. Arterial blood gases and ventilator settings were monitored every 6 hrs postinjury for up to 7 days. Measurements and Main Results: All animals survived the induction of injury. In the 24 smoke breath/40% total body surface area burn (24/40) group, PaO2/FIO2 never decreased below 300, and peak inspiratory pressure was consistently <14 cm H2O with normal arterial blood gases throughout the observation period. With 36 smoke breaths/40% total body surface area burn (36/40) (n = 7), all animals had PaO2/FIO2 of <200 and peak inspiratory pressure of 20 cm H2O within 40-48 hrs, as 30% died during the study period. With 48 smoke breaths/40% total body surface area burn (48/40) (n = 12), all animals developed respiratory distress syndrome (RDS) in 24-30 hrs, but none survived the experimental period. Conclusions: Development of RDS by smoke and cutaneous flame burn injury depends on smoke inhalation dose. A combination of 36 breaths of smoke and a 40% total body surface area (third-degree) cutaneous flame burn injury can induce severe RDS (PaO2/FIO2 <200) within 40-48 hrs to allow evaluation of various treatment modalities of RDS.

    Original languageEnglish (US)
    Pages (from-to)1469-1476
    Number of pages8
    JournalCritical Care Medicine
    Volume28
    Issue number5
    StatePublished - 2000

    Fingerprint

    Smoke
    Respiratory Insufficiency
    Inhalation
    Sheep
    Body Surface Area
    Skin
    Wounds and Injuries
    Smoke Inhalation Injury
    Gases
    Pressure
    Tracheostomy
    Bees
    Mechanical Ventilators
    Observation
    Temperature
    Research

    Keywords

    • Acute respiratory failure
    • Adult respiratory distress syndrome
    • Arteriovenous carbon dioxide removal
    • Burn injury
    • Ovine model
    • Sheep
    • Smoke inhalation

    ASJC Scopus subject areas

    • Critical Care and Intensive Care Medicine

    Cite this

    Alpard, S. K., Zwischenberger, J. B., Tao, W., Deyo, D. J., Traber, D. L., & Bidani, A. (2000). New clinically relevant sheep model of severe respiratory failure secondary to combined smoke inhalation/cutaneous flame injury. Critical Care Medicine, 28(5), 1469-1476.

    New clinically relevant sheep model of severe respiratory failure secondary to combined smoke inhalation/cutaneous flame injury. / Alpard, Scott K.; Zwischenberger, Joseph B.; Tao, Weike; Deyo, Donald J.; Traber, Daniel L.; Bidani, Akhil.

    In: Critical Care Medicine, Vol. 28, No. 5, 2000, p. 1469-1476.

    Research output: Contribution to journalArticle

    Alpard, SK, Zwischenberger, JB, Tao, W, Deyo, DJ, Traber, DL & Bidani, A 2000, 'New clinically relevant sheep model of severe respiratory failure secondary to combined smoke inhalation/cutaneous flame injury', Critical Care Medicine, vol. 28, no. 5, pp. 1469-1476.
    Alpard, Scott K. ; Zwischenberger, Joseph B. ; Tao, Weike ; Deyo, Donald J. ; Traber, Daniel L. ; Bidani, Akhil. / New clinically relevant sheep model of severe respiratory failure secondary to combined smoke inhalation/cutaneous flame injury. In: Critical Care Medicine. 2000 ; Vol. 28, No. 5. pp. 1469-1476.
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    abstract = "Objectives: To develop a predictable, dose-dependent, clinically relevant model of severe respiratory failure associated with a 40{\%} total body surface area, full-thickness (third-degree) cutaneous flame burn and smoke inhalation injury in adult sheep. Design: Model development. Setting: Research laboratory. Subjects: Adult female sheep (n = 22). Interventions: Animals were divided into three groups, determined by the number of smoke breaths administered (24, 36, 48) for a graded inhalation injury. The smoke was insufflated into a tracheostomy with a modified bee smoker at airway temperatures <40°C. All animals concurrently received a 40{\%} total body surface area (third-degree) cutaneous flame burn to the body (flanks). After injury, the animals were placed on volume-controlled ventilation to achieve PaO2 >60 mm Hg and PaCO2 <40 mm Hg. Arterial blood gases and ventilator settings were monitored every 6 hrs postinjury for up to 7 days. Measurements and Main Results: All animals survived the induction of injury. In the 24 smoke breath/40{\%} total body surface area burn (24/40) group, PaO2/FIO2 never decreased below 300, and peak inspiratory pressure was consistently <14 cm H2O with normal arterial blood gases throughout the observation period. With 36 smoke breaths/40{\%} total body surface area burn (36/40) (n = 7), all animals had PaO2/FIO2 of <200 and peak inspiratory pressure of 20 cm H2O within 40-48 hrs, as 30{\%} died during the study period. With 48 smoke breaths/40{\%} total body surface area burn (48/40) (n = 12), all animals developed respiratory distress syndrome (RDS) in 24-30 hrs, but none survived the experimental period. Conclusions: Development of RDS by smoke and cutaneous flame burn injury depends on smoke inhalation dose. A combination of 36 breaths of smoke and a 40{\%} total body surface area (third-degree) cutaneous flame burn injury can induce severe RDS (PaO2/FIO2 <200) within 40-48 hrs to allow evaluation of various treatment modalities of RDS.",
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    AU - Alpard, Scott K.

    AU - Zwischenberger, Joseph B.

    AU - Tao, Weike

    AU - Deyo, Donald J.

    AU - Traber, Daniel L.

    AU - Bidani, Akhil

    PY - 2000

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    N2 - Objectives: To develop a predictable, dose-dependent, clinically relevant model of severe respiratory failure associated with a 40% total body surface area, full-thickness (third-degree) cutaneous flame burn and smoke inhalation injury in adult sheep. Design: Model development. Setting: Research laboratory. Subjects: Adult female sheep (n = 22). Interventions: Animals were divided into three groups, determined by the number of smoke breaths administered (24, 36, 48) for a graded inhalation injury. The smoke was insufflated into a tracheostomy with a modified bee smoker at airway temperatures <40°C. All animals concurrently received a 40% total body surface area (third-degree) cutaneous flame burn to the body (flanks). After injury, the animals were placed on volume-controlled ventilation to achieve PaO2 >60 mm Hg and PaCO2 <40 mm Hg. Arterial blood gases and ventilator settings were monitored every 6 hrs postinjury for up to 7 days. Measurements and Main Results: All animals survived the induction of injury. In the 24 smoke breath/40% total body surface area burn (24/40) group, PaO2/FIO2 never decreased below 300, and peak inspiratory pressure was consistently <14 cm H2O with normal arterial blood gases throughout the observation period. With 36 smoke breaths/40% total body surface area burn (36/40) (n = 7), all animals had PaO2/FIO2 of <200 and peak inspiratory pressure of 20 cm H2O within 40-48 hrs, as 30% died during the study period. With 48 smoke breaths/40% total body surface area burn (48/40) (n = 12), all animals developed respiratory distress syndrome (RDS) in 24-30 hrs, but none survived the experimental period. Conclusions: Development of RDS by smoke and cutaneous flame burn injury depends on smoke inhalation dose. A combination of 36 breaths of smoke and a 40% total body surface area (third-degree) cutaneous flame burn injury can induce severe RDS (PaO2/FIO2 <200) within 40-48 hrs to allow evaluation of various treatment modalities of RDS.

    AB - Objectives: To develop a predictable, dose-dependent, clinically relevant model of severe respiratory failure associated with a 40% total body surface area, full-thickness (third-degree) cutaneous flame burn and smoke inhalation injury in adult sheep. Design: Model development. Setting: Research laboratory. Subjects: Adult female sheep (n = 22). Interventions: Animals were divided into three groups, determined by the number of smoke breaths administered (24, 36, 48) for a graded inhalation injury. The smoke was insufflated into a tracheostomy with a modified bee smoker at airway temperatures <40°C. All animals concurrently received a 40% total body surface area (third-degree) cutaneous flame burn to the body (flanks). After injury, the animals were placed on volume-controlled ventilation to achieve PaO2 >60 mm Hg and PaCO2 <40 mm Hg. Arterial blood gases and ventilator settings were monitored every 6 hrs postinjury for up to 7 days. Measurements and Main Results: All animals survived the induction of injury. In the 24 smoke breath/40% total body surface area burn (24/40) group, PaO2/FIO2 never decreased below 300, and peak inspiratory pressure was consistently <14 cm H2O with normal arterial blood gases throughout the observation period. With 36 smoke breaths/40% total body surface area burn (36/40) (n = 7), all animals had PaO2/FIO2 of <200 and peak inspiratory pressure of 20 cm H2O within 40-48 hrs, as 30% died during the study period. With 48 smoke breaths/40% total body surface area burn (48/40) (n = 12), all animals developed respiratory distress syndrome (RDS) in 24-30 hrs, but none survived the experimental period. Conclusions: Development of RDS by smoke and cutaneous flame burn injury depends on smoke inhalation dose. A combination of 36 breaths of smoke and a 40% total body surface area (third-degree) cutaneous flame burn injury can induce severe RDS (PaO2/FIO2 <200) within 40-48 hrs to allow evaluation of various treatment modalities of RDS.

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    KW - Adult respiratory distress syndrome

    KW - Arteriovenous carbon dioxide removal

    KW - Burn injury

    KW - Ovine model

    KW - Sheep

    KW - Smoke inhalation

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