TY  - BOOK
AU  - Carney, Bonnie C
AU  - Johnson, Laura
AU  - Luker, Jenna N
AU  - Moffatt, Lauren T
AU  - Monger, Kyle W
AU  - Shupp, Jeffrey W
AU  - Vazquez, Juan Sebastian
AU  - Vigiola Cruz, Mariana
TI  - Plasma Ameliorates Endothelial Dysfunction in Burn Injury
SN  - 0022-4804
PY  - 2019///
KW  - IN PROCESS -- NOT YET INDEXED
KW  - MedStar Health Research Institute
KW  - MedStar Washington Hospital Center
KW  - Firefighters' Burn and Surgical Research Laboratory
KW  - Surgery/Burn Services
KW  - Journal Article
N2  - BACKGROUND: A complex inflammatory response mediates the systemic effects of burn shock. Disruption of the endothelial glycocalyx causes shedding of structural glycoproteins, primarily syndecan-1 (SDC-1), leading to endothelial dysfunction. These effects may be mitigated by resuscitative interventions; CONCLUSIONS: Addition of FFP, not of albumin, to post-burn resuscitation diminishes vascular leakage associated with large burns. Addition of colloid does not affect SDC-1 shedding as measured in plasma. Ongoing work will further define pathophysiologic mechanisms and potential therapeutic interventions to mitigate injury and promote repair of the endothelial glycocalyx; Copyright (c) 2018 Elsevier Inc. All rights reserved; MATERIALS AND METHODS: Sprague-Dawley rats were used to create small, medium, and large burns and uninjured controls. Three different intravenous resuscitation protocols were applied within each group: Lactated Ringer's (LR) alone, LR plus fresh frozen plasma (FFP), or LR plus albumin. Blood was serially collected, and plasma SDC-1 was quantified with enzyme-linked immunosorbent assay. In one cohort, Evan's Blue Dye (EBD) was administered and quantified in lung by spectrophotometry as a functional assay of vascular permeability. In a second cohort, intact SCD-1 was quantified by immunohistochemistry in lung tissue. Statistical analysis employed two-way analysis of variance with multiple comparisons and Student's t-test; RESULTS: EBD extraction from lung was significantly greater with higher injury severity versus controls. Extraction decreased significantly in large-burn animals with addition of FFP to LR versus LR-only; addition of albumin to LR did not decrease EBD extraction. Plasma SCD-1 increased in injured animals compared with controls, and changes correlated with injury severity in all resuscitation groups (significance, P < 0.05). Lung SCD-1 staining reflected the results in the EBD assay
UR  - https://dx.doi.org/10.1016/j.jss.2018.08.027
ER  -