A comparison of effects of thermal injury and smoke inhalation on bacterial translocation.
Thermal injury as well as smoke inhalation injury results in serious morbidity and high mortality. In a chronic ovine model, we studied the development of bacterial translocation to the mesenteric lymph node, liver, spleen, kidney, and lung following: 1) sham injury (N = 6), 2) cutaneous thermal injury (N = 5), 3) cotton smoke inhalation injury (N = 4), 4) combined thermal injury and smoke inhalation injury (N = 7). Cardiac output, mean arterial pressure, and plasma protein concentration were maintained within 10% of preinjury values. Urine output was maintained above 1 ml/kg/hour with fluid and plasma resuscitation. A wide-beam ultrasonic flow probe was chronically implanted to allow serial measurement of cephalic mesenteric arterial blood flow throughout the 48-hour experimental period. Sheep were sacrificed 48 hours following injury for quantitative organ culture of mesenteric lymph node, liver, spleen, kidney, and lung. Measurements of mesenteric blood flow demonstrated a decrease to 48 +/- 8%, 80 +/- 5%, and 64 +/- 9% of preinjury levels in sheep receiving thermal injury, smoke inhalation injury, and combination injury, respectively. The sham animals maintained mesenteric blood flow at 102 +/- 7% of control levels. Thermal injury, as well as combination thermal and smoke inhalation injury, resulted in higher levels of translocation than smoke inhalation injury alone.
Morris
S E
SE
Department of Surgery, Shriners Burns Institute, University of Texas Medical Branch, Galveston.
Navaratnam
N
N
Herndon
D N
DN
D000818:Animals; D001419:Bacteria / Q000254:growth & development; D002056:Burns / Q000382:microbiology* / Q000503:physiopathology; D002302:Cardiac Output; D007668:Kidney / Q000382:microbiology; D008099:Liver / Q000382:microbiology; D008168:Lung / Q000382:microbiology; D008198:Lymph Nodes / Q000382:microbiology; D008638:Mesenteric Arteries / Q000503:physiopathology; D012756:Sheep; D015208:Smoke Inhalation Injury / Q000382:microbiology* / Q000503:physiopathology; D013152:Splanchnic Circulation; D013154:Spleen / Q000382:microbiology