Airway obstruction in sheep with burn and smoke inhalation injuries
Airway obstruction in sheep with burn and smoke inhalation injuries
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DOI：
10.1165/rcmb.4860
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发表时间：
2003-09-01
影响因子：
6.4
通讯作者：
Hawkins, HK
中科院分区：
文献类型：
--
作者：
Cox, RA;Burke, AS;Hawkins, HK
本研究的目的是（i）比较因吸入烟雾和/或烧伤引起肺损伤的绵羊气道阻塞的程度和（ii）时间变化； (W) 定性评估阻塞性物质的细胞和粘液含量； (iv) 统计评估气道阻塞程度与肺功能障碍之间可能存在的关系。使用遮蔽的组织学切片，我们估计了所有横截面气道的管腔阻塞程度。与单独烧伤或未受伤的动物相比，单独烟雾损伤或烟雾吸入和烧伤（S+B）联合损伤的动物的支气管、细支气管和终末细支气管阻塞的平均程度显着更大（P < 0.05）。在S+B动物中，支气管阻塞程度在24小时时达到最大，并在72小时内逐渐减少。相反，细支气管阻塞的程度随着时间的推移而增加。从定性上看，受伤后早期支气管管型主要由粘液组成，而中性粒细胞是细支气管阻塞物质的主要成分。 S+B 组织中特定粘蛋白亚型的定位表明，细支气管阻塞的增加部分源自上呼吸道物质。气道阻塞评分与 Pa-O2/Fl(O2) 值相比的多元线性回归分析显示，相关系数为 r = 0.76，支气管和细支气管评分可预测 Pa-O2/Fl(O2)（P < 0.05）。这些结果表明，去除或减少上呼吸道阻塞物质形成的策略可能会减少其沉积到小气道和实质中，并可能改善烟雾吸入性损伤患者的呼吸功能。
The goals of this study were (i) to compare the degree and (ii) temporal changes in airway obstruction in sheep with pulmonary injury induced by smoke inhalation and/or burn; (W) to qualitatively assess the cellular and mucous content of obstructive material; and (iv) to statistically assess a possible relationship between the degree of airway obstruction and pulmonary dysfunction. Using masked histologic slides, we estimated the degree of luminal obstruction in all cross-sectioned airways. The mean degree of bronchial, bronchiolar, and terminal bronchiolar obstruction was significantly greater in animals with smoke injury alone or combined smoke inhalation and burn (S+B) injury, compared with animals with burn injury alone or uninjured animals (P < 0.05). In S+B animals, the degree of bronchial obstruction was maximal at 24 h, with a progressive decrease over 72 h. In contrast, the degree of bronchiolar obstruction increased over time. Qualitatively, bronchial casts were largely composed of mucus at early times after injury, whereas neutrophils were the principal component of bronchiolar obstructive material. Localization of specific mucin subtypes in S+B tissues suggests that increasing bronchiolar obstruction is derived, in part, from upper airway material. Multiple linear regression analysis of airway obstruction scores compared with Pa-O2/Fl(O2) values showed a correlation coefficient of r = 0.76, with bronchial and bronchiolar scores predictive of Pa-O2 /Fl(O2), (P < 0.05). These results suggest that strategies to remove or decrease formation of upper airway obstructive material may reduce its deposition into small airways and parenchyma and may improve respiratory function in victims of smoke inhalation injury.