Surprising finding from smoke inhalation study

Apr 01, 2011

An award-winning Loyola University Health System study includes some unexpected findings about the immune systems of smoke-inhalation patients.

Contrary to expectations, patients who died from their injuries had lower inflammatory responses in their lungs than patients who survived.

"Perhaps a better understanding of this early pulmonary will allow for therapies that further improve outcomes in ," researchers reported.

Results were released at the 43rd annual meeting of the American Burn Association. The project won the 2011 Carl A. Moyer Resident Award for the best study submitted by a resident physician.

First author of the study is Christopher S. Davis, MD, a general surgery resident at Loyola University Hospital. Corresponding author is Elizabeth J. Kovacs, PhD, associate director of the Burn & Shock Trauma Institute at Loyola University Chicago Stritch School of Medicine.

Researchers followed 60 burn patients at the Loyola University Hospital Burn Center. The severity of inhalation injury was categorized into one of five grades (0, 1, 2, 3, and 4), with zero being the absence of visible injury.

As expected, patients with the worst combined burn-and-smoke-inhalation injuries required more time on the ventilator, in the intensive care unit and in the hospital. They also were more likely to die, although this finding fell just short of being statistically significant.

Also according to expectations, patients who died were older and had larger injuries than patients who survived.

But the findings were unexpected. Researchers measured concentrations of 28 immune system modulators in fluid collected from the lungs of patients within 14 hours of burn and smoke-inhalation injuries.

These modulators are proteins produced by leukocytes (white blood cells) and other cells, including those that line the airway. Some of the modulators recruit leukocytes to areas of tissue damage or activate them to begin the repair process that follows tissue injury.

Based on studies conducted at Loyola and other centers, researchers had expected to find higher concentrations of modulators in patients who died, because sicker patients tend to have more active inflammatory responses. But researchers found just the opposite: patients who died had lower concentrations of these modulators in their lungs.

Why do some patients mount robust immune responses in the lungs while others do not? The reason may be due to age, genetics, differences in patients' underlying health conditions or anything that might disrupt the balance between too much and too little inflammation, Davis said.

Survival of burn patients has significantly improved since the 1950s, due to advancements such as better wound care and improved prevention and treatment of infections. But progress has somewhat stalled in the last 10 years.

"It appears that the inflammatory and immune response to injury remains incompletely understood and that additional effort is required to further improve survival of the burn-injured patient," researchers wrote.

Explore further: Cold cash just keeps washing in from ALS challenge

add to favorites email to friend print save as pdf

Related Stories

Alcohol damages much more than the liver

Nov 11, 2010

Alcohol does much more harm to the body than just damaging the liver. Drinking also can weaken the immune system, slow healing, impair bone formation, increase the risk of HIV transmission and hinder recovery from burns, ...

Burn injuries take devastating toll on nation's children

Nov 12, 2007

The approach of winter season brings with it an increase in burn-related injuries to our nation’s children. Annually in the United States, fires and burns result in almost 4,000 deaths and more than 745,000 non-hospitalized ...

Burn injuries rapidly deplete vitamin E

Oct 20, 2010

Severe burn injuries in children have been shown to rapidly deplete the levels of vitamin E in their body's adipose, or fat tissues, a new clinical study has found.

Virtual game helps children escape realities of burn unit

Oct 09, 2007

Nurses and physicians at Nationwide Children’s Hospital are using the latest technology to help young burn victims endure the extreme pain of dressing changes and wound care. Instead of traditional distraction ...

Recommended for you

Cold cash just keeps washing in from ALS challenge

Aug 28, 2014

In the couple of hours it took an official from the ALS Association to return a reporter's call for comment, the group's ubiquitous "ice bucket challenge" had brought in a few million more dollars.

Medtronic spends $350M on another European deal

Aug 27, 2014

U.S. medical device maker Medtronic is building stronger ties to Europe, a couple months after announcing a $42.9 billion acquisition that involves moving its main executive offices across the Atlantic, where it can get a ...

Mind over matter for people with disabilities

Aug 26, 2014

People with serious physical disabilities are unable to do the everyday things that most of us take for granted despite having the will – and the brainpower – to do so. This is changing thanks to European ...

Ukraine's former world's tallest man dies

Aug 25, 2014

Ukraine's tallest man, who briefly held the world record but gave it up to live as a recluse, has died due to complications from the condition that saw him never stop growing, local media reported Monday.

User comments : 0