NDLI: Tracheobronchial markers of lung injury in smoke inhalation victims.

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Tracheobronchial markers of lung injury in smoke inhalation victims.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kurzius-Spencer, Margaret Foster, Kevin Littau, Sally Richey, Karen J. Clark, Beth M. Sherrill, Duane Goodman, Richard B. Boitano, Scott Burgess, Jefferey L.
Description	Country affiliation: United States Author Affiliation: Kurzius-Spencer M ( Division of Community, Environment and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ 85724, USA.)
Abstract	Although smoke inhalation injury victims frequently develop severe hypoxemia and are at increased risk of acute respiratory distress syndrome (ARDS), no early prognostic tests are currently available. The objectives were to determine early longitudinal changes in tracheobronchial fluid inflammatory markers and assess the value of initial concentrations as predictors of subsequent lung injury. Partial pressure of arterial oxygen (Pao2) and the fraction of inspired oxygen (Fio2) were recorded approximately every 6 hours from intubated smoke inhalation victims admitted to a regional burn center. Tracheobronchial suction fluid was collected every 2 hours and assayed for interleukins (IL-1beta, -8, and -10), tumor necrosis factor-alpha, transforming growth factor-beta1, soluble Fas ligand (sFasL), and complement factor 5a. Temporal trends in marker concentrations during 36 hours and the relations between initial concentrations and lowest Pao2/Fio2 or ARDS within 72 hours were assessed using random coefficients modeling and cross-sectional analysis. In 21 subjects with tracheobronchial samples collected within 6.5 hours of intubation, 14 (66.7%) developed acute hypoxemia (Pao2/Fio2 < or =200) within 72 hours of exposure and nine (42.9%) developed ARDS, as defined by the American-European consensus conference on ARDS. IL-8 increased sharply in the first 6.5 hours postexposure (P < .001), and IL-1beta in the first 6.1 hours (P < .001). No significant temporal trends in IL-10, tumor necrosis factor-alpha, transforming growth factor-beta1, sFasL, or complement factor 5a were found. Only initial IL-8 was associated with increased Pao2/Fio2 (P = .013) and with a minimum Pao2/Fio2 >200 (P = .042) during 72 hours. In smoke inhalation victims, tracheobronchial IL-1beta and IL-8 increase rapidly and high initial IL-8 may predict improved oxygenation.
File Format	HTM / HTML
ISSN	1559047X
Issue Number	2
Volume Number	29
e-ISSN	15590488
Journal	Journal of Burn Care & Research
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2008-03-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Traumatology Biological Markers Inflammation Physiopathology Respiratory Distress Syndrome, Adult Etiology Smoke Inhalation Injury Complications Adolescent Adult Burns Cross-sectional Studies Epithelial Cells Female Health Status Indicators Humans Longitudinal Studies Male Prognosis Diagnosis Risk Factors Time Factors Journal Article Research Support, U.s. Gov't, Non-p.h.s.
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine Rehabilitation Surgery

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