Local Inflammation in Fracture Hematoma: Results from a Combined Trauma Model in Pigs

Abstract

Background. Previous studies showed significant interaction between the local and systemic inflammatory response after severe trauma in small animal models. The purpose of this study was to establish a new combined trauma model in pigs to investigate fracture-associated local inflammation and gain information about the early inflammatory stages after polytrauma. Material and Methods. Combined trauma consisted of tibial fracture, lung contusion, liver laceration, and controlled hemorrhage. Animals were mechanically ventilated and under ICU-monitoring for 48 h. Blood and fracture hematoma samples were collected during the time course of the study. Local and systemic levels of serum cytokines and diverse alarmins were measured by ELISA kit. Results. A statistical significant difference in the systemic serum values of IL-6 and HMGB1 was observed when compared to the sham. Moreover, there was a statistical significant difference in the serum values of the fracture hematoma of IL-6, IL-8, IL-10, and HMGB1 when compared to the systemic inflammatory response. However a decrease of local proinflammatory concentrations was observed while anti-inflammatory mediators increased. Conclusion. Our data showed a time-dependent activation of the local and systemic inflammatory response. Indeed it is the first study focusing on the local and systemic inflammatory response to multiple-trauma in a large animal model.

Characterization of blunt chest trauma in a long-term porcine model of severe multiple trauma

“…inspiratory oxygen fraction (FiO 2 ) of 0.5; positive end-expiratory pressure (PEEP) 8 mmHg (plateau pressure < 28 mmHg) adjusted by capnometry targeting a pCO 2 of 35–45 mmHg (Draeger, Evita, Lübeck, Germany) as indicated for the treatment of patients with chest trauma7374. Vital parameters were monitored by electrocardiographic (ECG) recordings and ECG-synchronized pulse oximetry, as previously described75. Data on vital signs are depicted according to the time points of whole blood sampling.…”

“…Furthermore, for blunt chest trauma induction a pair of panels (steel: 0.8 cm and lead: 1.0 cm thickness) was placed on the right dorsal, lower chest. The bolt was shot (Blitz-Kerner, turbocut JOBB GmbH, Germany) onto this panel using cattle-killing cartridges (9 × 17; Dynamit Nobel AG, Troisdorf, Germany) simulating blunt lung contusion as previously described7576. The bolt shot was applied while the lungs of the animals were inflated.…”

The cytokines and micro‐environment of fracture haematoma: Current evidence

“…IL‐6 is a cytokine secreted by macrophages, neutrophils, and lymphocytes in response to traumatic insult (Bastian et al, ; Scheller, Chalaris, Schmidt‐Arras, & Rose‐John, ). It is an acute phase cytokine that is present at early stages in fracture haematoma (Hauser et al, ; Hoff et al, ; Horst et al, ; Wu et al, ). Horst et al () measured the IL‐6 levels in fracture haematoma in pigs following a tibial fracture.…”

Advantages and Dangers of Early Osteosynthesis of Femur in Polytrauma With Chest Injur

“…Нейтрофилы и макро-фаги составляют наиболее многочисленную популя-цию клеток иммунной системы в гематоме в области перелома кости. Продукция активированными в очаге повреждения эффекторными иммунными клетками провоспалительных цитокинов (IL-6, IL-8, амфотерина HMGB1) приводит к усилению локального и систем-ного воспалительного эффекта, вызывающего пов-реждение легких [23,24]. В эксперименте на модели сочетания двустороннего ушиба легкого с перело-мом бедренной кости и повреждением мягких тканей контралатерального бедра отмечена более ранняя и выраженная системная воспалительная реакция (СВР) с высоким уровнем активности миелопероксидазы и апоптоза альвеоцитов, чем при изолированных трав-мах.…”