Development of an In Vivo Model of Laryngeal Burn Injury
Development of an In Vivo Model of Laryngeal Burn Injury
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DOI：
10.1002/lary.26123
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发表时间：
2017-01-01
期刊：
影响因子：
2.6
通讯作者：
Branski, Ryan C.
中科院分区：
文献类型：
--
作者：
Dion, Gregory R.;Teng, Stephanie;Branski, Ryan C.
目的/假设：吸入性损伤显著增加烧伤患者的发病率和死亡率。大约五分之一的烧伤患者有喉、气管和/或肺的急性损伤，多达70%的患者有长期的喉异常。虽然吸入性肺损伤已被广泛研究，没有模型存在，以研究这些侮辱喉。因此，我们开发了一种体内兔模型，以创建精确和可重复的喉烧伤，并由此产生组织损伤，作为介入研究的基础。无管气管切开术后，使用自定义温度控制装置施加加热空气（70摄氏度-80摄氏度、150摄氏度-160摄氏度或310摄氏度-320摄氏度）+/-未漂白棉产生的烟雾通过内窥镜到达喉部，最大限度地减少6只家兔的相邻组织损伤。监测疼痛、营养和活动水平。直接喉镜检查和组织学检查进行24小时后insult.Results：所有动物存活损伤与适当的疼痛控制;口服摄入量开始，所有通过气管切开术充分通气。烧伤后遗症在损伤后24小时在直接可视化下观察到，并且观察到作为温度的函数的分级水平的水肿和组织损伤。水肿阻碍了真正的声带可视化在温度升高。这些损伤模式与分级组织损伤histologic.Conclusion：我们创建了一个喉烧伤的体内模型，采用定制的烧伤装置，导致分级组织损伤。该模型对于研究烧伤的潜在机制以及最终开发和评估针对这一具有挑战性人群的治疗方法至关重要。
Objectives/Hypothesis: Inhalation injury significantly increases morbidity and mortality in burn patients. Approximately one in five burn patients have acute injury to the larynx, trachea, and/or lungs-and as many as 70% have long-term laryngeal abnormalities. Although inhalation injury to the lung has been studied extensively, no models exist to study these insults to the larynx. As such, we developed an in vivo rabbit model to create precise and reproducible laryngeal burn with resultant tissue damage as a foundation for interventional studies.Methods: Following tubeless tracheotomy, a custom temperature-control device was employed to apply heated air (70 degrees C-80 degrees C, 150 degrees C-160 degrees C, or 310 degrees C-320 degrees C) +/- smoke derived from unbleached cotton to the larynx, endoscopically, minimizing adjacent tissue damage in six rabbits. Pain, nutrition, and level of activity were monitored. Direct laryngoscopy and histological examination were performed 24 hours following insult.Results: All animals survived injury with appropriate pain control; oral intake was initiated and all were adequately ventilating via tracheostomy. Burn sequelae were noted under direct visualization 24 hours after injury, and graded levels of edema and tissue damage were observed as a function of temperature. Edema obstructed true vocal fold visualization at increased temperatures. These injury patterns correlated with graded tissue damage on histology.Conclusion: We created an in vivo model of laryngeal burn injury employing a custom burn device resulting in graded tissue injury. This model is critical for investigation of the mechanisms underlying burn injury, and ultimately, the development and evaluation of therapies for this challenging population.