PMID- 24986596
OWN - NLM
STAT- MEDLINE
DCOM- 20150909
LR  - 20201209
IS  - 1879-1409 (Electronic)
IS  - 0305-4179 (Linking)
VI  - 41
IP  - 1
DP  - 2015 Feb
TI  - High-frequency percussive ventilation and initial biomarker levels of lung injury 
      in patients with minor burns after smoke inhalation injury.
PG  - 65-70
LID - S0305-4179(14)00172-7 [pii]
LID - 10.1016/j.burns.2014.05.007 [doi]
AB  - BACKGROUND: Several biological markers of lung injury are predictors of morbidity 
      and mortality in patients with acute respiratory distress syndrome (ARDS). Some 
      lung-protective ventilation strategies, such as low tidal volume, are associated 
      with a significant decrease in plasma biomarker levels compared to the high tidal 
      volume ventilation strategy. The primary objective of this study was to test 
      whether the institution of high-frequency percussive ventilation (HFPV) to 
      patients with respiratory distress after smoke inhalation injury influenced 
      initial biomarker levels of lung injury (just before and after using percussive 
      ventilation). MATERIALS AND METHODS: A prospective observational cohort study was 
      conducted in the intensive care unit of the Brussels Burn Center. Fifteen 
      intubated, mechanically ventilated patients with minor burns and ARDS following 
      smoke inhalation were enrolled in our study. Physiologic data and serum samples 
      were collected before intubation and at four different time points within the 
      first 48h after intubation to measure the concentration of interleukin (IL)-6, 
      IL-8, and tumor necrosis factor-alpha (TNF alpha). The differences in biomarker 
      levels before and after starting HFPV were analyzed using repeated measure 
      analysis of variance and a paired t test with correction for multiple 
      comparisons. RESULTS: Before starting HFPV under endotracheal intubation, all 
      biological markers (IL-6, IL-8, and TNF alpha) were elevated in the spontaneously 
      breathing patients with acute lung injury (ALI). After intubation and institution 
      of a positive pressure ventilation with HFPV (tidal volume 5.6-6.6ml/kg per ideal 
      body weight), none of the biological markers were increased significantly at 
      either an early (3+/-2h) or a later point in time. However, the levels of IL-8 had 
      decreased significantly after intubation at a later point in time. During the 
      post-intubation period, the PaO2/FiO2 (partial pressure of arterial 
      oxygen/fraction of the inspired oxygen) ratio increased significantly and the 
      plateau airway pressure decreased significantly. CONCLUSION: Levels of IL-6, 
      IL-8, and TNF alpha are elevated in spontaneously ventilating patients with minor 
      burns and ARDS following smoke exposition prior to endotracheal intubation. The 
      institution of HFPV with percussive positive pressure ventilation enhances blood 
      oxygenation and could not further increase the initial levels of these biological 
      markers of lung injury after smoke inhalation injury.
CI  - Copyright (c) 2014 Elsevier Ltd and ISBI. All rights reserved.
FAU - Reper, P
AU  - Reper P
AD  - Critical Care Department, Queen Astrid Hospital and Free University of Brussels, 
      Brussels, Belgium. Electronic address: pascal.reper@chu-brugmann.be.
FAU - Heijmans, W
AU  - Heijmans W
AD  - Critical Care Department, Queen Astrid Hospital and Free University of Brussels, 
      Brussels, Belgium.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20140628
PL  - Netherlands
TA  - Burns
JT  - Burns : journal of the International Society for Burn Injuries
JID - 8913178
RN  - 0 (Biomarkers)
RN  - 0 (CXCL8 protein, human)
RN  - 0 (IL6 protein, human)
RN  - 0 (Interleukin-6)
RN  - 0 (Interleukin-8)
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
CIN - Burns. 2016 Aug;42(5):1141. PMID: 27211363
MH  - Adult
MH  - Biomarkers/blood
MH  - Burn Units
MH  - Burns/complications/therapy
MH  - Cohort Studies
MH  - Female
MH  - High-Frequency Ventilation/*methods
MH  - Humans
MH  - Interleukin-6/*blood
MH  - Interleukin-8/*blood
MH  - Male
MH  - Middle Aged
MH  - Positive-Pressure Respiration
MH  - Prospective Studies
MH  - Respiratory Distress Syndrome/blood/etiology/*therapy
MH  - Smoke Inhalation Injury/blood/complications/*therapy
MH  - Tidal Volume
MH  - Tumor Necrosis Factor-alpha/*blood
MH  - Ventilator-Induced Lung Injury/blood/prevention & control
MH  - Young Adult
OTO - NOTNLM
OT  - Biomarkers
OT  - Burn
OT  - Respiratory distress
OT  - Smoke inhalation injury
EDAT- 2014/07/06 06:00
MHDA- 2015/09/10 06:00
CRDT- 2014/07/03 06:00
PHST- 2014/01/10 00:00 [received]
PHST- 2014/05/06 00:00 [revised]
PHST- 2014/05/09 00:00 [accepted]
PHST- 2014/07/03 06:00 [entrez]
PHST- 2014/07/06 06:00 [pubmed]
PHST- 2015/09/10 06:00 [medline]
AID - S0305-4179(14)00172-7 [pii]
AID - 10.1016/j.burns.2014.05.007 [doi]
PST - ppublish
SO  - Burns. 2015 Feb;41(1):65-70. doi: 10.1016/j.burns.2014.05.007. Epub 2014 Jun 28.