title: Nebulization with γ-tocopherol ameliorates acute lung injury after burn and smoke inhalation in the ovine model.
abstract: We hypothesize that the nebulization of γ-tocopherol (g-T) in the airway of our ovine model of acute respiratory distress syndrome will effectively improve pulmonary function following burn and smoke inhalation after 96 h. Adult ewes (n = 14) were subjected to 40% total body surface area burn and were insufflated with 48 breaths of cotton smoke under deep anesthesia, in a double-blind comparative study. A customized aerosolization device continuously delivered g-T in ethanol with each breath from 3 to 48 h after the injury (g-T group, n = 6), whereas the control group (n = 5) was nebulized with only ethanol. Animals were weaned from the ventilator when possible. All animals were killed after 96 h, with the exception of one untreated animal that was killed after 64 h. Lung g-T concentration significantly increased after g-T nebulization compared with the control group (38.5 ± 16.8 vs. 0.39 ± 0.46 nmol/g, P < 0.01). The PaO(2)/FIO(2) ratio was significantly higher after treatment with g-T compared with the control group (310 ± 152 vs. 150 ± 27.0, P < 0.05). The following clinical parameters were improved with g-T treatment: pulmonary shunt fraction, peak and pause pressures, lung bloodless wet-to-dry weight ratios (2.9 ± 0.87 vs. 4.6 ± 1.4, P < 0.05), and bronchiolar obstruction (2.0% ± 1.1% vs. 4.6% ± 1.7%, P < 0.05). Nebulization of g-T, carried by ethanol, improved pulmonary oxygenation and markedly reduced the time necessary for assisted ventilation in burn- and smoke-injured sheep. Delivery of g-T into the lungs may be a safe, novel, and efficient approach for management of acute lung injury patients who have sustained oxidative damage to the airway.
authors.affiliation: Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas 77555, USA.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Perenlei
authors.initials: P
authors.lastname: Enkhbaatar
authors.forename: Linda E
authors.initials: LE
authors.lastname: Sousse
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakurai
authors.forename: Sebastian W
authors.initials: SW
authors.lastname: Rehberg
authors.forename: Sven
authors.initials: S
authors.lastname: Asmussen
authors.forename: Edward R
authors.initials: ER
authors.lastname: Kraft
authors.forename: Charlotte L
authors.initials: CL
authors.lastname: Wright
authors.forename: Eva
authors.initials: E
authors.lastname: Bartha
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cox
authors.forename: Hal K
authors.initials: HK
authors.lastname: Hawkins
authors.forename: Lillian D
authors.initials: LD
authors.lastname: Traber
authors.forename: Maret G
authors.initials: MG
authors.lastname: Traber
authors.forename: Csaba
authors.initials: C
authors.lastname: Szabo
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Traber
mesh_terms: D055371:Acute Lung Injury / Q000188:drug therapy* / Q000209:etiology*; D000818:Animals; D002056:Burns / Q000150:complications*; D005260:Female; D009330:Nebulizers and Vaporizers; D012756:Sheep; D015208:Smoke Inhalation Injury / Q000150:complications*; D024504:gamma-Tocopherol / Q000008:administration & dosage* / Q000627:therapeutic use*
chemical_list: D024504:gamma-Tocopherol