Severe depression of host immune functions following closed-bone fracture, soft-tissue trauma, and hemorrhagic shock.
OBJECTIVE
To determine the contribution of soft-tissue trauma plus hemorrhage, bone fracture and hemorrhage, as well as the contribution of bone fracture, soft-tissue trauma and hemorrhage on host immune function.


METHODS
Adult male mice (n = 6/group).


METHODS
Prospective, randomized, controlled study.


METHODS
Animal laboratory at a university-affiliated hospital.


METHODS
Closed-bone fracture (right lower leg; external fixation) and/or soft-tissue trauma (2.5-cm midline laparotomy, closed in two layers) were induced before hemorrhagic shock (mean arterial blood pressure of 35 +/- 5 (SEM) mm Hg for 90 mins, followed by fluid resuscitation) in male C3H/HeN mice and the animals were killed at 72 hrs after initiation of the experiment.


RESULTS
Splenocyte interleukin (IL)-2 and IL-3 release capacity, as well as splenic and peritoneal macrophage IL-1 and IL-6 release capacity were determined. Different traumatic insults, i.e., bone fracture or soft-tissue trauma in conjunction with hemorrhage, produced comparable immune depression. More significant depression of splenocyte IL-2 and IL-3 release capacity as well as macrophage IL-1 and IL-6 release capacity occurred with the combined insult (i.e., bone fracture/soft-tissue injury and hemorrhage) than after bone injury or tissue trauma alone with hemorrhage.


CONCLUSIONS
The combination of closed-bone fracture and soft-tissue trauma before hemorrhage leads to even more compromised immunity than either soft-tissue trauma or closed-bone fracture along with hemorrhage. The markedly depressed immune function following bone injury, soft-tissue trauma, and hemorrhagic shock may contribute to the increased susceptibility of severely injured patients to sepsis and the ensuing multiple organ failure in the clinical situation.
Wichmann
M W
MW
Center for Surgical Research and Department of Surgery, Brown University School of Medicine and Rhode Island Hospital, Providence 02903, USA.
Ayala
A
A
Chaudry
I H
IH
D000818:Animals; D002460:Cell Line; D002478:Cells, Cultured; D005596:Fractures, Closed / Q000276:immunology* / Q000378:metabolism; D007107:Immune System / Q000502:physiology*; D007378:Interleukins / Q000378:metabolism; D017737:Macrophages, Peritoneal / Q000276:immunology; D008297:Male; D051379:Mice; D008809:Mice, Inbred C3H; D009104:Multiple Trauma / Q000276:immunology* / Q000378:metabolism; D011897:Random Allocation; D012771:Shock, Hemorrhagic / Q000276:immunology* / Q000378:metabolism; D017695:Soft Tissue Injuries / Q000276:immunology* / Q000378:metabolism; D013154:Spleen / Q000276:immunology
D007378:Interleukins