Robert A Cox1, Sam Jacob2, Clark R Andersen3, Ron Mlcak4, Linda Sousse3, Yong Zhu2, Christopher Cotto2, Celeste C Finnerty5, Perenlei Enkhbaatar6, David N Herndon3, Hal K Hawkins2. 1. Departments of Pathology, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States. Electronic address: rocox@utmb.edu. 2. Departments of Pathology, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States. 3. Departments of Surgery, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States. 4. Departments of Respiratory Therapy, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States. 5. 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. 6. Departments of Anesthesiology, Shriners Hospital for Children, University of Texas Medical Branch, Galveston, TX, United States.
Abstract
UNLABELLED: 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.
UNLABELLED: 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: Sam Jacob; Yong Zhu; Robert Kraft; Christopher Cotto; Joseph R Carmical; Thomas G Wood; Perenlei Enkhbaatar; David N Herndon; Hal K Hawkins; Robert A Cox Journal: Int J Burns Trauma Date: 2015-03-20