title: Impact of bronchial circulation on bronchial exudates following combined burn and smoke inhalation injury in sheep.
abstract: We previously reported bronchial circulation contributes to pulmonary edema and increases shunt fraction following smoke inhalation, and bronchial blood flow significantly increases in inhalation injury. We hypothesized reduction of bronchial blood flow reduces exudation to the airway and ameliorates lung injury from combined burn and smoke insults (B&S injury).
  
  
  METHODS
  Merino ewes (n=28) randomly divided into three groups: (1) bronchial artery ligated and injured (injury+ligation group); (2) bronchial artery left intact and injured (injury+no ligation group); (3) bronchial artery ligated but not injured (no injury+ligation group) were subjected to a flame burn and inhalation injury under halothane anesthesia. Parameters were analyzed using Scheffe's post hoc test (P<0.05). All Groups were resuscitated with Ringer lactate solution and placed on a ventilator for 48h.
  
  
  RESULTS
  Pulmonary gas exchange (PaO(2)/FiO(2)) improved in injury+ligation group. Further, obstruction score, an index of airway cast formation, significantly changed between injury+no ligation group compared to both ligation groups.
  
  
  CONCLUSIONS
  Bronchial circulation plays a significant role in lung injury after B&S injury, and reduction of bronchial blood flow by bronchial artery ligation reduces bronchial exudates, resulting in improved gas exchange.
authors.affiliation: Department of Anesthesiology, The University of Texas Medical Branch and Shriners Hospital for Children, Galveston, TX 77555, USA.
authors.forename: Naoki
authors.initials: N
authors.lastname: Morita
authors.forename: Perenlei
authors.initials: P
authors.lastname: Enkhbaatar
authors.forename: Dirk M
authors.initials: DM
authors.lastname: Maybauer
authors.forename: Marc O
authors.initials: MO
authors.lastname: Maybauer
authors.forename: Martin
authors.initials: M
authors.lastname: Westphal
authors.forename: Kazunori
authors.initials: K
authors.lastname: Murakami
authors.forename: Hal K
authors.initials: HK
authors.lastname: Hawkins
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cox
authors.forename: Lillian D
authors.initials: LD
authors.lastname: Traber
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Traber
mesh_terms: D000818:Animals; D001981:Bronchial Arteries / Q000503:physiopathology; D002056:Burns / Q000503:physiopathology*; D005122:Exudates and Transudates / Q000502:physiology; D005260:Female; D006439:Hemodynamics; D010100:Oxygen / Q000097:blood; D011652:Pulmonary Circulation / Q000502:physiology*; D011897:Random Allocation; D034561:Sheep, Domestic; D015208:Smoke Inhalation Injury / Q000503:physiopathology*
chemical_list: D010100:Oxygen