title: Predictive role of arterial carboxyhemoglobin concentrations in ovine burn and smoke inhalation-induced lung injury.
abstract: Inhalation injury frequently occurs in burn patients and contributes to the morbidity and mortality of these injuries. Arterial carboxyhemoglobin has been proposed as an indicator of the severity of inhalation injury; however, the interrelation between arterial carboxyhemoglobin and histological alterations has not yet been investigated. Chronically instrumented sheep were subjected to a third degree burn of 40% of the total body surface area and inhalation of 48 breaths of cotton smoke. Carboxyhemoglobin was measured immediately after injury and correlated to clinical parameters of pulmonary function as well as histopathology scores from lung tissue harvested 24 hours after the injury. The injury was associated with a significant decline in pulmonary oxygenation and increases in pulmonary shunting, lung lymph flow, wet/dry weight ratio, congestion score, edema score, inflammation score, and airway obstruction scores. Carboxyhemoglobin was negatively correlated to pulmonary oxygenation and positively correlated to pulmonary shunting, lung lymph flow, and lung wet/dry weight ratio. No significant correlations could be detected between carboxyhemoglobin and histopathology scores and airway obstruction scores. Arterial carboxyhemoglobin in sheep with combined burn and inhalation injury are correlated with the degree of pulmonary failure and edema formation, but not with certain histological alterations including airway obstruction scores.
authors.affiliation: Department of Anesthesiology, Investigational Intensive Care Unit, University of Texas Medical Branch and Shriners Burns Hospital for Children, Galveston, Texas 77550, USA. lanm@gmx.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Lange
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cox
authors.forename: Perenlei
authors.initials: P
authors.lastname: Enkhbaatar
authors.forename: Elbert B
authors.initials: EB
authors.lastname: Whorton
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Nakano
authors.forename: Atsumori
authors.initials: A
authors.lastname: Hamahata
authors.forename: Collette
authors.initials: C
authors.lastname: Jonkam
authors.forename: Aimalohi
authors.initials: A
authors.lastname: Esechie
authors.forename: Sanna
authors.initials: S
authors.lastname: von Borzyskowski
authors.forename: Lillian D
authors.initials: LD
authors.lastname: Traber
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Traber
mesh_terms: D000818:Animals; D001830:Body Surface Area; D002056:Burns / Q000473:pathology*; D002263:Carboxyhemoglobin / Q000032:analysis*; D055370:Lung Injury; D011237:Predictive Value of Tests; D012756:Sheep; D015208:Smoke Inhalation Injury / Q000473:pathology*
chemical_list: D002263:Carboxyhemoglobin