| Preclinical evaluation of epinephrine nebulization to reduce airway hyperemia and improve oxygenation after smoke inhalation injury. | |
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MedLine Citation:
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PMID: 21263320 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Acute lung injury secondary to smoke inhalation is a major source of morbidity and mortality in burn patients. We tested the hypothesis that nebulized epinephrine would ameliorate pulmonary dysfunction secondary to acute lung injury by reducing airway hyperemia and edema formation and mediating bronchodilatation in an established, large animal model of inhalation injury. DESIGN: Prospective, controlled, randomized trial. SETTING: University research laboratory. SUBJECTS: Twenty-four chronically instrumented, adult, female sheep. INTERVENTIONS: Following baseline measurements, the animals were allocated to a sham-injured group (n = 5), an injured and saline-treated group (n = 6), or an injured group treated with 4 mg of nebulized epinephrine every 4 hrs (n = 6). Inhalation injury was induced by 48 breaths of cotton smoke. The dose of epinephrine was derived from dose finding experiments (n = 7 sheep). MEASUREMENTS AND MAIN RESULTS: The injury induced significant increases in airway blood flows, bronchial wet/dry weight ratio, airway obstruction scores, ventilatory pressures, and lung malondialdehyde content, and contributed to severe pulmonary dysfunction as evidenced by a significant decline in Pao₂/Fio₂ ratio and increase in pulmonary shunt fraction. Nebulization of epinephrine significantly reduced tracheal and main bronchial blood flows, ventilatory pressures, and lung malondialdehyde content. The treatment was further associated with significant improvements of Pao₂/FIO₂ ratio and pulmonary shunting. CONCLUSIONS: Nebulization of epinephrine reduces airway blood flow and attenuates pulmonary dysfunction in sheep subjected to severe smoke inhalation injury. Future studies will have to improve the understanding of the underlying pathomechanisms and identify the optimal dosing for the treatment of patients with this injury. |
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Authors:
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Matthias Lange; Atsumori Hamahata; Daniel L Traber; Robert A Cox; Gabriela A Kulp; Yoshimitsu Nakano; Lillian D Traber; David N Herndon; Perenlei Enkhbaatar |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 39 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-05-25 Completed Date: 2011-07-29 Revised Date: 2012-01-26 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 718-24 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Investigational Intensive Care Unit, The University of Texas Medical Branch and Shriners Hospitals for Children, Galveston, TX, USA. lanm@gmx.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Disease Models, Animal Dose-Response Relationship, Drug Epinephrine / administration & dosage, therapeutic use* Female Hemodynamics / drug effects Hyperemia / drug therapy*, etiology Nebulizers and Vaporizers Pulmonary Circulation / drug effects Pulmonary Edema / drug therapy, etiology Pulmonary Gas Exchange / drug effects Sheep Smoke Inhalation Injury / complications, drug therapy* |
| Grant Support | |
ID/Acronym/Agency:
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GM60915/GM/NIGMS NIH HHS; P012 GM066312/GM/NIGMS NIH HHS; R01 GM060688/GM/NIGMS NIH HHS |
| Chemical | |
Reg. No./Substance:
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51-43-4/Epinephrine |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2012 Jan;40(1):355-6; author reply 356-7
[PMID:
22179383
]
Crit Care Med. 2011 Apr;39(4):891-3 [PMID: 21613840 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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