title: Integrity of airway epithelium in pediatric burn autopsies: Association with age and extent of burn injury.
abstract: This study examines the structural integrity of the airway epithelium in autopsy tissues from pediatric burn subjects.
  
  
  METHODS
  A semi-quantitative score for the degree of airway epithelial integrity was made for seventy- two pediatric burn autopsies. Multivariate ordinal logistic regression was performed to identify relationships between epithelial integrity and conditions related to tissue fixation, time of death after injury, age, total body surface area burn (TBSA), extent of 3rd degree burn, presence of inhalation injury, ventilator days and pneumonia.
  
  
  RESULTS
  No significant difference in epithelial integrity scores was identified between burn only cases and those with inhalation injury. Significant correlations with bronchiolar epithelial integrity scores were identified for age, p=0.02, and percent 3rd degree burn, p=0.02. There was no significant relationship between epithelial integrity and time between death and autopsy, p>0.44.
  
  
  CONCLUSIONS
  Airway epithelial loss seen in autopsy tissue is not simply an artifact of tissue fixation. The degree of compromise correlates most strongly with age and degree of burn. Further studies are needed to identify physiological or critical care factors following burn injury that contribute to compromise in the structural and functional properties of the airway epithelium.
authors.affiliation: Departments of Pathology, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States. Electronic address: rocox@utmb.edu.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cox
authors.affiliation: Departments of Pathology, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Sam
authors.initials: S
authors.lastname: Jacob
authors.affiliation: Departments of Surgery, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Clark R
authors.initials: CR
authors.lastname: Andersen
authors.affiliation: Departments of Respiratory Therapy, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Ron
authors.initials: R
authors.lastname: Mlcak
authors.affiliation: Departments of Surgery, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Linda
authors.initials: L
authors.lastname: Sousse
authors.affiliation: Departments of Pathology, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Departments of Pathology, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Christopher
authors.initials: C
authors.lastname: Cotto
authors.affiliation: Departments of Surgery, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States; Institute for Translational Sciences, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Celeste C
authors.initials: CC
authors.lastname: Finnerty
authors.affiliation: Departments of Anesthesiology, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Perenlei
authors.initials: P
authors.lastname: Enkhbaatar
authors.affiliation: Departments of Surgery, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.affiliation: Departments of Pathology, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Hal K
authors.initials: HK
authors.lastname: Hawkins
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001344:Autopsy; D001980:Bronchi / Q000473:pathology; D002056:Burns / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D020545:Respiratory Mucosa / Q000473:pathology*; D015208:Smoke Inhalation Injury / Q000473:pathology; D055815:Young Adult
keywords: Infection; Innate defense; Mucociliary function; Pneumonia; Trauma