Matthias Fröhlich1, Frank Hildebrand, Matthias Weuster, Philipp Mommsen, Juliane Mohr, Ingo Witte, Pierre Raeven, Steffen Ruchholtz, Sascha Flohé, Martijn van Griensven, Hans-Christoph Pape, Roman Pfeifer. 1. From the Department of Orthopaedic Trauma and Reconstructive Surgery (M.F., F.H., H.-C.P., R.P.), University Hospital Aachen, Aachen; Department of Orthopaedic Trauma Surgery (M.W.), University of Schleswig-Holstein, Kiel; Trauma Department (P.M.), Hannover Medical School, Hannover; Department of Trauma, Hand and Reconstructive Surgery (J.M., S.R.), University Hospital Marburg, Marburg; Department of Trauma and Hand-Surgery (I.W., S.F.), University of Duesseldorf, Duesseldorf; and Experimental Trauma Surgery (M.V.G.), Clinic for Trauma Surgery, Klinikum rechts der Isar, Technical University, Munich, Germany; and Ludwig Boltzmann Institute for Experimental and Clinical Traumatology (P.R., M.V.G.), Vienna, Austria.
Abstract
BACKGROUND: Mild therapeutic hypothermia following trauma has been introduced in several studies to reduce the posttraumatic inflammation and organ injury. In this study, we analyzed the effects of induced mild hypothermia (34°C) on the inflammation of the shock organs liver and kidney. METHODS: In a porcine model of multiple trauma including blunt chest trauma, liver laceration, and hemorrhagic shock followed by fluid resuscitation, the influence of induced hypothermia on hepatic and renal damage and organ-specific inflammation were evaluated. A total of 40 pigs were randomly assigned to four groups, which were sham (anesthesia only) or trauma groups receiving either hypothermia or normothermia. The parameters analyzed were laboratory parameters (aspartate transaminase [AST], lactate dehydrogenase, urea, creatinine) as well as hepatic and renal cytokine expression determined by real-time polymerase chain reaction (interleukin 6 [IL-6], IL-8). Blinded analysis of histologic changes in the liver and kidney was performed. RESULTS: Fifteen and a half hours following combined trauma, hepatic cytokine expression and liver damage were significantly increased in animals with normothermia compared with the respective sham group. Hypothermia, however, resulted in a fivefold reduced hepatic expression of IL-8 (mean ± SE, 2.4 ± 1.3; p = 0.01) when compared with the normothermic trauma group (IL-8, 12.8 ± 4.7). Accordingly, granulocyte infiltration and a histologic, semiquantitative score for liver injury were significantly higher in the normothermic trauma group. Serum AST levels raised significantly after trauma and normothermia compared with the respective sham group, while AST levels showed no difference from the sham groups in the hypothermic trauma group. In contrast, neither trauma nor hypothermia influenced the expression of IL-6 and IL-8 and tissue injury in the kidney. CONCLUSION: Therapeutic hypothermia seems to attenuate the hepatic inflammatory response and the associated liver injury after severe trauma. Therefore, induced hypothermia might represent a potential therapeutic strategy to avoid posttraumatic organ dysfunction.
BACKGROUND: Mild therapeutic hypothermia following trauma has been introduced in several studies to reduce the posttraumatic inflammation and organ injury. In this study, we analyzed the effects of induced mild hypothermia (34°C) on the inflammation of the shock organs liver and kidney. METHODS: In a porcine model of multiple trauma including blunt chest trauma, liver laceration, and hemorrhagic shock followed by fluid resuscitation, the influence of induced hypothermia on hepatic and renal damage and organ-specific inflammation were evaluated. A total of 40 pigs were randomly assigned to four groups, which were sham (anesthesia only) or trauma groups receiving either hypothermia or normothermia. The parameters analyzed were laboratory parameters (aspartate transaminase [AST], lactate dehydrogenase, urea, creatinine) as well as hepatic and renal cytokine expression determined by real-time polymerase chain reaction (interleukin 6 [IL-6], IL-8). Blinded analysis of histologic changes in the liver and kidney was performed. RESULTS: Fifteen and a half hours following combined trauma, hepatic cytokine expression and liver damage were significantly increased in animals with normothermia compared with the respective sham group. Hypothermia, however, resulted in a fivefold reduced hepatic expression of IL-8 (mean ± SE, 2.4 ± 1.3; p = 0.01) when compared with the normothermic trauma group (IL-8, 12.8 ± 4.7). Accordingly, granulocyte infiltration and a histologic, semiquantitative score for liver injury were significantly higher in the normothermic trauma group. Serum AST levels raised significantly after trauma and normothermia compared with the respective sham group, while AST levels showed no difference from the sham groups in the hypothermic trauma group. In contrast, neither trauma nor hypothermia influenced the expression of IL-6 and IL-8 and tissue injury in the kidney. CONCLUSION: Therapeutic hypothermia seems to attenuate the hepatic inflammatory response and the associated liver injury after severe trauma. Therefore, induced hypothermia might represent a potential therapeutic strategy to avoid posttraumatic organ dysfunction.
Authors: Neil A Hukriede; Danielle E Soranno; Veronika Sander; Tayla Perreau; Michelle C Starr; Peter S T Yuen; Leah J Siskind; Michael P Hutchens; Alan J Davidson; David M Burmeister; Sarah Faubel; Mark P de Caestecker Journal: Nat Rev Nephrol Date: 2022-02-16 Impact factor: 42.439
Authors: K Horst; D Eschbach; R Pfeifer; B Relja; M Sassen; T Steinfeldt; H Wulf; N Vogt; M Frink; S Ruchholtz; H C Pape; F Hildebrand Journal: PLoS One Date: 2016-05-04 Impact factor: 3.240