Vitamin E attenuates acute lung injury in sheep with burn and smoke inhalation injury.
BACKGROUND
A decrease in alpha-tocopherol (vitamin E) plasma levels in burn patients is typically associated with increased mortality. We hypothesized that vitamin E supplementation (alpha-tocopherol) would attenuate acute lung injury induced by burn and smoke inhalation injury.


METHODS
Under deep anesthesia, sheep (33 +/- 5 kg) were subjected to a flame burn (40% total body surface area, third degree) and inhalation injury (48 breaths of cotton smoke, < 40 degrees C). Half of the injured group received alpha-tocopherol (1000 IU vitamin E) orally, 24 h prior to injury. The sham group was neither injured nor given vitamin E. All three groups (n = 5 per group) were resuscitated with Ringer's lactate solution (4 ml/kg/%burn/24 h), and placed on a ventilator (PEEP = 5 cmH2O; tidal volume = 15 ml/kg) for 48 h.


RESULTS
Plasma alpha-tocopherol per lipids doubled in the vitamin E treated sheep. Vitamin E treatment prior to injury largely prevented the increase in pulmonary permeability index and moderated the increase in lung lymph flow (52.6 +/- 6.2 ml/min, compared with 27.3 +/- 6.0 ml/min, respectively), increased the PaO2/FiO2 ratio, ameliorated both peak and pause airway pressure increases, and decreased plasma conjugated dienes and nitrotyrosine.


CONCLUSIONS
Pretreatment with vitamin E ameliorated the acute lung injury caused by burn and smoke inhalation exposure.
Morita
Naoki
N
The University of Texas Medical Branch, Department of Anaesthesiology and Shriners Burns Hospital for Children, Galveston, Texas, USA.
Shimoda
Katsumi
K
Traber
Maret G
MG
Westphal
Martin
M
Enkhbaatar
Perenlei
P
Murakami
Kazunori
K
Leonard
Scott W
SW
Traber
Lillian D
LD
Traber
Daniel L
DL