Hypobaria Exposure Worsens Cardiac Function and Endothelial Injury in AN Animal Model of Polytrauma: Implications for Aeromedical Evacuation.
Shock
; 56(4): 601-610, 2021 10 01.
Article
em En
| MEDLINE
| ID: mdl-33394971
ABSTRACT
BACKGROUND:
Aeromedical evacuation can expose traumatically injured patients to low pressure (hypobaria) and hypoxia. Here, we sought to assess the impact of hypobaria on inflammation, organ injury, and mortality in a mouse model of polytrauma.METHODS:
Eight to 12-week-old male C57BL/6J mice were subjected to sham or polytrauma consisting of bowel ischemia by superior mesenteric artery occlusion, hindlimb muscle crush, and tibia fracture. Two hours after injury, animals were randomized to undergo either 6âh of hypobaria or sea-level, room air conditions. At 8 or 24âh after injury, transthoracic echocardiography was performed. Acute kidney injury (AKI) biomarkers were measured by qRT-PCR. Plasma cytokine and endothelial injury markers were determined by enzyme-linked immunosorbent assay.RESULTS:
Eight hours after traumatic injury, mice exhibited a marked increase in plasma IL-6 (57 pg/mL vs. 1,216âpg/mL), AKI with increased Ngal and Kim-1, and endothelial injury as evidenced by significantly increased plasma hyaluronic acid (96âng/mL vs.199âng/mL), thrombomodulin (23.2âng/mL vs. 58.9âng/mL), syndecan-1 (0.99âng/mL vs. 4.34âng/mL), and E-selectin (38.6âng/mL vs. 62.7âng/mL). The trauma mice also developed cardiac dysfunction with decreased cardiac output and stroke volume at 8âh postinjury. Hypobaric exposure after polytrauma led to decreased ejection fraction (81.0% vs. 74.2%, Pâ<â0.01) and increased plasma hyaluronic acid (199âng/mL vs. 260âng/mL, Pâ<â0.05), thrombomodulin (58.9âng/mL vs. 75.4âng/mL, Pâ<â0.05), and syndecan-1 (4.34âng/mL vs. 8.33âng/mL, Pâ<â0.001) at 8âh postinjury.CONCLUSIONS:
Hypobaria exposure appeared to worsen cardiac dysfunction and endothelial injury following polytrauma and thus may represent a physiological "second hit" following traumatic injury.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Endotélio Vascular
/
Traumatismo Múltiplo
/
Resgate Aéreo
/
Pressão do Ar
/
Injúria Renal Aguda
Limite:
Animals
Idioma:
En
Revista:
Shock
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article