M W Wichmann1, A Ayala, I H Chaudry. 1. Center for Surgical Research and Department of Surgery, Brown University School of Medicine and Rhode Island Hospital, Providence 02903, USA.
Abstract
OBJECTIVE: To determine the contribution of soft-tissue trauma plus hemorrhage, bone fracture and hemorrhage, as well as the contribution of bone fracture, soft-tissue trauma and hemorrhage on host immune function. SUBJECTS: Adult male mice (n = 6/group). DESIGN: Prospective, randomized, controlled study. SETTING: Animal laboratory at a university-affiliated hospital. INTERVENTIONS: Closed-bone fracture (right lower leg; external fixation) and/or soft-tissue trauma (2.5-cm midline laparotomy, closed in two layers) were induced before hemorrhagic shock (mean arterial blood pressure of 35 +/- 5 (SEM) mm Hg for 90 mins, followed by fluid resuscitation) in male C3H/HeN mice and the animals were killed at 72 hrs after initiation of the experiment. MEASUREMENTS AND MAIN RESULTS: Splenocyte interleukin (IL)-2 and IL-3 release capacity, as well as splenic and peritoneal macrophage IL-1 and IL-6 release capacity were determined. Different traumatic insults, i.e., bone fracture or soft-tissue trauma in conjunction with hemorrhage, produced comparable immune depression. More significant depression of splenocyte IL-2 and IL-3 release capacity as well as macrophage IL-1 and IL-6 release capacity occurred with the combined insult (i.e., bone fracture/soft-tissue injury and hemorrhage) than after bone injury or tissue trauma alone with hemorrhage. CONCLUSIONS: The combination of closed-bone fracture and soft-tissue trauma before hemorrhage leads to even more compromised immunity than either soft-tissue trauma or closed-bone fracture along with hemorrhage. The markedly depressed immune function following bone injury, soft-tissue trauma, and hemorrhagic shock may contribute to the increased susceptibility of severely injured patients to sepsis and the ensuing multiple organ failure in the clinical situation.
OBJECTIVE: To determine the contribution of soft-tissue trauma plus hemorrhage, bone fracture and hemorrhage, as well as the contribution of bone fracture, soft-tissue trauma and hemorrhage on host immune function. SUBJECTS: Adult male mice (n = 6/group). DESIGN: Prospective, randomized, controlled study. SETTING: Animal laboratory at a university-affiliated hospital. INTERVENTIONS: Closed-bone fracture (right lower leg; external fixation) and/or soft-tissue trauma (2.5-cm midline laparotomy, closed in two layers) were induced before hemorrhagic shock (mean arterial blood pressure of 35 +/- 5 (SEM) mm Hg for 90 mins, followed by fluid resuscitation) in male C3H/HeN mice and the animals were killed at 72 hrs after initiation of the experiment. MEASUREMENTS AND MAIN RESULTS: Splenocyte interleukin (IL)-2 and IL-3 release capacity, as well as splenic and peritoneal macrophage IL-1 and IL-6 release capacity were determined. Different traumatic insults, i.e., bone fracture or soft-tissue trauma in conjunction with hemorrhage, produced comparable immune depression. More significant depression of splenocyte IL-2 and IL-3 release capacity as well as macrophage IL-1 and IL-6 release capacity occurred with the combined insult (i.e., bone fracture/soft-tissue injury and hemorrhage) than after bone injury or tissue trauma alone with hemorrhage. CONCLUSIONS: The combination of closed-bone fracture and soft-tissue trauma before hemorrhage leads to even more compromised immunity than either soft-tissue trauma or closed-bone fracture along with hemorrhage. The markedly depressed immune function following bone injury, soft-tissue trauma, and hemorrhagic shock may contribute to the increased susceptibility of severely injured patients to sepsis and the ensuing multiple organ failure in the clinical situation.
Authors: Rachael P Jackman; Garth H Utter; Marcus O Muench; John W Heitman; Matthew M Munz; Robert W Jackman; Hope H Biswas; Ryan M Rivers; Leslie H Tobler; Michael P Busch; Philip J Norris Journal: Transfusion Date: 2012-03-27 Impact factor: 3.157
Authors: R J Rentenaar; J de Metz; M Bunders; P M Wertheim-van Dillen; D J Gouma; J A Romijn; H P Sauerwein; I J ten Berge; R A van Lier Journal: Clin Exp Immunol Date: 2001-09 Impact factor: 4.330
Authors: Richard S Hotchkiss; Katherine C Chang; Mitchell H Grayson; Kevin W Tinsley; Benjamin S Dunne; Christopher G Davis; Dale F Osborne; Irene E Karl Journal: Proc Natl Acad Sci U S A Date: 2003-05-07 Impact factor: 11.205
Authors: Lori F Gentile; Dina C Nacionales; Alex G Cuenca; Michael Armbruster; Ricardo F Ungaro; Amer S Abouhamze; Cecelia Lopez; Henry V Baker; Frederick A Moore; Darwin N Ang; Philip A Efron Journal: Crit Care Med Date: 2013-04 Impact factor: 7.598
Authors: Brian B Chesebro; Pamela Rahn; Michel Carles; Charles T Esmon; Jun Xu; Karim Brohi; Daniel Frith; Jean-François Pittet; Mitchell J Cohen Journal: Shock Date: 2009-12 Impact factor: 3.454