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10. [alpha]-Tocopherol adipose tissue stores are depleted after burn injury in pediatric patients.

Author

Traber MG, Leonard SW, Traber DL, Traber LD, Gallagher J, Bobe G, Jeschke MG, Finnerty CC, and Herndon D

Abstract

BACKGROUND: We previously showed that thermal injury depletes plasma vitamin E in pediatric burn patients; however, plasma changes may reflect immediate alterations in vitamin E nutriture. Adipose tissue [alpha]-tocopherol concentrations are generally accepted to reflect long-term vitamin E status. OBJECTIVE: To test the hypothesis that thermal injury depletes body stores of vitamin E, [alpha]-tocopherol concentrations were measured in adipose tissue samples. DESIGN: Pediatric patients (n = 8) were followed up to 1 y after burn injury. Surgically obtained samples were collected at various intervals and stored at -80°C in a biorepository. [alpha]- and [gamma]-Tocopherols, cholesterol, and triglycerides were measured in the same tissue aliquot. RESULTS: During the first week after injury, adipose tissue [alpha]-tocopherol concentrations were within the expected normal range of 199 ± 40 nmol/g adipose tissue but were substantially lower at weeks 2 and 3 (133 ± 13 and 109 ± 8 nmol/g adipose tissue, respectively). Individual rates of decrease, estimated by linear regression, showed that adipose tissue [alpha]-tocopherol decreased by an average of 6.1 ± 0.6 nmol/g daily. During the first month after injury, adipose tissue triglyceride concentrations also decreased, whereas no changes in cholesterol concentrations occurred. CONCLUSIONS: These data emphasize that the burn injury experienced by these pediatric patients altered their metabolism such that vitamin E status diminished during the month after injury. Further studies are needed to evaluate the mechanism and consequences of the observed vitamin E depletion. This trial was registered at clinicaltrials.gov as NCT00675714. © 2010 American Society for Nutrition [ABSTRACT FROM AUTHOR]

Published
2010
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48. Microvascular changes in large flame burn wound in sheep.

Author

Sakurai H, Nozaki M, Traber LD, Hawkins HK, Traber DL, Sakurai, Hiroyuki, Nozaki, Motohiro, Traber, Lillian D, Hawkins, Hal K, and Traber, Daniel L

Abstract

Advances in local wound management with early excisional therapy have decreased morbidity and mortality of massive third-degree burn patients. Although blood redistribution within burned tissue is of clinical interest, few studies have longitudinally determined the regional blood flow of various layers of the burn wound. We used a conscious ovine model in which animals were subjected to 40% third degree burn. Burned tissue was divided into the four layers (i.e. skin, panniculus carnosus, adipose tissue, and skeletal muscle), and regional blood flow was determined separately, with fluorescent microspheres, while measuring systemic hemodynamics and total burned tissue microvascular fluid flux. The subburn adipose tissue exhibited a remarkable biphasic alteration in regional blood flow, whereas the skin layer showed only decreased blood flow during the whole experimental period. The increase in blood flow to the adipose tissue seems to be related to a sustained fluid filtrate in the postresuscitation period, resulting in edema formation mainly located in the adipose tissue at the endpoint. [ABSTRACT FROM AUTHOR]

Published
2002
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50. Pulmonary histopathologic abnormalities and predictor variables in autopsies of burned pediatric patients.

Author

Sousse LE, Herndon DN, Andersen CR, Zovath A, Finnerty CC, Mlcak RP, Cox RA, Traber DL, and Hawkins HK

Subjects
Acute Lung Injury complications, Adolescent, Autopsy, Child, Child, Preschool, Cohort Studies, Female, Fibrosis complications, Fibrosis pathology, Hemorrhage complications, Hemorrhage pathology, Humans, Hyalin, Infant, Infant, Newborn, Male, Pulmonary Edema complications, Pulmonary Edema pathology, Respiratory Distress Syndrome complications, Retrospective Studies, Smoke Inhalation Injury complications, Time Factors, Acute Lung Injury pathology, Burns complications, Lung pathology, Respiratory Distress Syndrome pathology, Smoke Inhalation Injury pathology
Abstract

Unlabelled: Pulmonary abnormalities occur in 30-80% of fatalities after burn. The objective of our study is to investigate lung pathology in autopsy tissues of pediatric burn patients., Methods: Three scientists with pathology training in pediatric burn care reviewed masked autopsy slides of burned children who died after admission to a burn center from 2002 to 2012 (n=43). Autopsy lung tissue was assigned scores for histologic abnormalities in 9 categories, including alveolar and interstitial fibrosis, hyaline membranes, and type II epithelial cell proliferation. Scores were then tested for correlation with age, TBSA burn, number of days between burn and death, time between burn and admission, and the presence of inhalation injury using analyses with linear models., Results: Type II epithelial cell proliferation was significantly more common in cases with a longer time between burn and admission (p<0.02). Interstitial fibrosis was significantly more severe in cases with longer survival after burn (p<0.01). The scores for protein were significantly higher in cases with longer survival after burn (p<0.03). Enlarged air spaces were significantly more prominent in cases with longer survival after burn (p<0.01), and in cases with the presence of inhalation injury (p<0.01)., Conclusions: Histological findings associated with diffuse alveolar damage (DAD), which is the pathological correlate of the acute respiratory distress syndrome (ARDS), were seen in approximately 42% of autopsies studied. Protein-rich alveolar edema, which is the abnormality that leads to ARDS, may occur from multiple causes, including inhalation injury., (Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.)

Published
2015
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