Hypertonic saline dextran after burn injury decreases inflammatory cytokine responses to subsequent pneumonia-related sepsis.
The present study examined the hypothesis that hypertonic saline dextran (HSD), given after an initial insult, attenuates exaggerated inflammation that occurs with a second insult. Adult rats (n = 15 per group) were divided into groups 1 (sham burn), 2 [40% total body surface area burn + 4 ml/kg isotonic saline (IS) + 4 ml.kg(-1).% burn(-1) lactated Ringer solution (LR)], and 3 (burn + 4 ml/kg HSD + LR), all studied 24 h after burns. Groups 4 (sham burn), 5 (burn + IS + LR), and 6 (burns + HSD + LR) received intratracheal (IT) vehicle 7 days after burns; groups 7 (burn + IS + LR) and 8 (burn + HSD + LR) received IT Streptococcus pneumoniae (4 x 10(6) colony-forming units) 7 days after burn. Groups 4-8 were studied 8 days after burn and 24 h after IT septic challenge. When compared with sham burn, contractile defects occurred 24 h after burn in IS-treated but not HSD-treated burns. Cardiac inflammatory responses (pg/ml TNF-alpha) were evident with IS (170 +/- 10) but not HSD (45 +/- 5) treatment vs. sham treatment (80 +/- 15). Pneumonia-related sepsis 8 days after IS-treated burns (group 7) exacerbated TNF-alpha responses/contractile dysfunction vs. IS-treated burns in the absence of sepsis (P < 0.05). Sepsis that occurred after HSD-treated burns (group 8) had less myocyte TNF-alpha secretion/better contractile function than IS-treated burns given septic challenge (group 7, P < 0.05). We conclude that an initial burn injury exacerbates myocardial inflammation/dysfunction occurring with a second insult; giving HSD after the initial insult attenuates myocardial inflammation/dysfunction associated with a second hit, suggesting that HSD reduces postinjury risk for infectious complications.
Horton
Jureta W
JW
Dept. of Surgery, UT Southwestern Medical Center, Dallas, TX 75390-9160, USA. jureta.horton@utsouthwestern.edu
Maass
David L
DL
White
D Jean
DJ
D000818:Animals; D002056:Burns / Q000150:complications / Q000188:drug therapy* / Q000276:immunology*; D016207:Cytokines / Q000276:immunology*; D003911:Dextrans / Q000008:administration & dosage*; D009200:Myocardial Contraction / Q000187:drug effects / Q000276:immunology; D009205:Myocarditis / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D011023:Pneumonia, Staphylococcal / Q000150:complications / Q000188:drug therapy* / Q000276:immunology*; D051381:Rats; D011920:Rats, Inbred WF; D012965:Sodium Chloride / Q000008:administration & dosage*; D016896:Treatment Outcome
D016207:Cytokines; D003911:Dextrans; C104375:hypertonic saline-dextran solution; D012965:Sodium Chloride