title: Characterization of blunt chest trauma in a long-term porcine model of severe multiple trauma.
abstract: Chest trauma has a significant relevance on outcome after severe trauma. Clinically, impaired lung function typically occurs within 72 hours after trauma. However, the underlying pathophysiological mechanisms are still not fully elucidated. Therefore, we aimed to establish an experimental long-term model to investigate physiological, morphologic and inflammatory changes, after severe trauma. Male pigs (sus scrofa) sustained severe trauma (including unilateral chest trauma, femur fracture, liver laceration and hemorrhagic shock). Additionally, non-injured animals served as sham controls. Chest trauma resulted in severe lung damage on both CT and histological analyses. Furthermore, severe inflammation with a systemic increase of IL-6 (p = 0.0305) and a local increase of IL-8 in BAL (p = 0.0009) was observed. The pO2/FiO2ratio in trauma animals decreased over the observation period (p < 0.0001) but not in the sham group (p = 0.2967). Electrical Impedance Tomography (EIT) revealed differences between the traumatized and healthy lung (p < 0.0001). In conclusion, a clinically relevant, long-term model of blunt chest trauma with concomitant injuries has been developed. This reproducible model allows to examine local and systemic consequences of trauma and is valid for investigation of potential diagnostic or therapeutic options. In this context, EIT might represent a radiation-free method for bedside diagnostics.
authors.affiliation: Department of Orthopaedic Trauma, RWTH Aachen University, Germany.|Harald Tscherne Research Laboratory, RWTH Aachen University, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Horst
authors.affiliation: Department of Intensive Care and Intermediate Care, RWTH Aachen University, Germany.
authors.forename: T P
authors.initials: TP
authors.lastname: Simon
authors.affiliation: Department of Orthopaedic Trauma, RWTH Aachen University, Germany.|Harald Tscherne Research Laboratory, RWTH Aachen University, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Pfeifer
authors.affiliation: Department of Orthopaedic Trauma, RWTH Aachen University, Germany.|Harald Tscherne Research Laboratory, RWTH Aachen University, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Teuben
authors.affiliation: Department of Orthopaedic Trauma, RWTH Aachen University, Germany.|Harald Tscherne Research Laboratory, RWTH Aachen University, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Almahmoud
authors.affiliation: Harald Tscherne Research Laboratory, RWTH Aachen University, Germany.
authors.forename: Q
authors.initials: Q
authors.lastname: Zhi
authors.affiliation: Chair for Medical Information Technology, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany.
authors.forename: S Aguiar
authors.initials: SA
authors.lastname: Santos
authors.affiliation: Chair for Medical Information Technology, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany.
authors.forename: C Castelar
authors.initials: CC
authors.lastname: Wembers
authors.affiliation: Chair for Medical Information Technology, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Leonhardt
authors.affiliation: Department of Medical Statistics, RWTH Aachen University, Germany.|Medical School, Sigmund Freud Private University, Vienna, Austria.
authors.forename: N
authors.initials: N
authors.lastname: Heussen
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, University of Frankfurt/Main, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Störmann
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, University of Frankfurt/Main, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Auner
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, University of Frankfurt/Main, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Relja
authors.affiliation: Department of Trauma-, Hand- and Reconstructive Surgery, University of Frankfurt/Main, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Marzi
authors.affiliation: Experimental Trauma Surgery, Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Germany.
authors.forename: A T
authors.initials: AT
authors.lastname: Haug
authors.affiliation: Experimental Trauma Surgery, Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: van Griensven
authors.affiliation: Department of Orthopedic Trauma, Hand-, Plastic-, and Reconstructive Surgery, University of Ulm, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kalbitz
authors.affiliation: Department of Orthopedic Trauma, Hand-, Plastic-, and Reconstructive Surgery, University of Ulm, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Huber-Lang
authors.affiliation: Institute for Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Tolba
authors.affiliation: Institute of Pharmacology and Toxicology, RWTH Aachen University, Germany.
authors.forename: L K
authors.initials: LK
authors.lastname: Reiss
authors.affiliation: Institute of Pharmacology and Toxicology, RWTH Aachen University, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Uhlig
authors.affiliation: Department of Intensive Care and Intermediate Care, RWTH Aachen University, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Marx
authors.affiliation: Department of Orthopaedic Trauma, RWTH Aachen University, Germany.
authors.forename: H C
authors.initials: HC
authors.lastname: Pape
authors.affiliation: Department of Orthopaedic Trauma, RWTH Aachen University, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Hildebrand
mesh_terms: D000818:Animals; D001992:Bronchoalveolar Lavage Fluid; D004195:Disease Models, Animal; D017097:Electric Impedance; D006439:Hemodynamics; D007249:Inflammation / Q000473:pathology; D015850:Interleukin-6 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D008168:Lung / Q000503:physiopathology; D055370:Lung Injury / Q000503:physiopathology; D008297:Male; D009104:Multiple Trauma / Q000503:physiopathology; D012771:Shock, Hemorrhagic / Q000473:pathology; D013552:Swine; D013898:Thoracic Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014054:Tomography; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: D015850:Interleukin-6; D016209:Interleukin-8