31 - Freie Mitteilung
15. Mai 2019, 15:30 - 17:00, Szenario 1, 5. OG
The acute systemic and local inflammatory response to severe trauma: An analysis in a porcine multiple trauma model
M. Canic, S. Halvachizadeh, P. Cinelli, M. Teuben, R. Pfeifer, N. Cesarovic, H.-C. Pape, Presenter: M. Canic (Zürich)
Severe injury leads to inflammatory responses that may lead to devastating outcome such as systemic inflammatory response syndrome, multiple organ failure or acute respiratory distress syndrome. The aim of this study was to analyze the acute inflammatory response after multiple injury and hemorrhagic shock.
The standardized multiple trauma included a femoral shaft fracture, blunt thoracic trauma a liver laceration and a mean arterial pressure controlled (MAP) hemorrhagic shock (group PT). The control group suffered the standardized femoral shaft fracture (group MT). The animals endured a trauma/shock of one hour prior to definitive stabilization of the fracture and fluid resuscitation. The total observational period was six hours after the initiation of trauma. Femoral shaft fractures were treated with retrograde nailing; resuscitation after shock included a volume substitution with preheated Ringer-Lactate. The systemic inflammation was measured with ELISA (IL-6, IL-10) at baseline (BL), trauma (Tr), Resuscitation and after two and four hours after trauma and at termination. Soft tissue analysis were performed with PCR (IL-6, IL-10, IL-8, HMGB1, HSP70) of local soft tissue harvested from the fracture site at baseline and at termination, as well as from the contralateral site at termination.
We included 27 animals in group PT and 25 animals in group MT. Group PT showed a significant increase in systemic IL-10 after one hour after resuscitation until the end of observational period (p<0.02). Further, our data show significant differences in systemic IL-6 values when comparing group PT to group MT (p<0.008). The local increase in IL-6 and IL-10 of fatty tissue is higher in group MT compared to group PT. Despite no statistical significance, there is little evidence, that the variance of changes in local IL-6 and IL-10 is not similar comparing group MT and group PT.
Not only do the systemic inflammatory responses differ but also the variance of local inflammatory response after standardized trauma when comparing multiple injured to monotrauma. These result indicate a reciprocal influence of local and systemic inflammatory response after trauma.