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Ex Vivo Pulmonary Oedema after In Vivo Blast-Induced Rat Lung Injury: Time Dependency, Blast Intensity and Beta-2 Adrenergic Receptor Role

Affiliation
Department of Cardiothoracic Surgery, Völklingen Heart Centre, 66333 Völklingen, Germany
Huwer, Hanno;
ORCID
0000-0002-6285-4912
Affiliation
Pneumology, Clinic for General Internal Medicine, Lindenhofspital Bern, 3012 Bern, Switzerland
Hadizamani, Yalda;
Affiliation
Lungen-und Atmungsstiftung, Bern, 3012 Bern, Switzerland
Moehrlen, Ueli;
Affiliation
Lungen-und Atmungsstiftung, Bern, 3012 Bern, Switzerland
Stammberger, Uz;
Affiliation
Department of Traumatology, Hand-, Plastic-, and Reconstructive Surgery, Center of Surgery, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
Gebhard, Florian;
ORCID
0000-0003-1993-7672
Affiliation
Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
Bally, Lia;
Affiliation
Biochemical Pharmacology, Department of Biology, University of Konstanz, 78457 Konstanz, Germany
Wendel, Albrecht;
Affiliation
Department of Trauma, Hand, Plastic and Reconstructive Surgery, University of Ulm-Surgical Center, Steinhövelstraße 9, 89075 Ulm, Germany
Liener, Ulrich C.;
ORCID
0000-0003-3805-8868
Affiliation
Vascular Biology Center, Augusta University, Augusta, GA 30912, USA
Lucas, Rudolf;
Affiliation
Pneumology, Clinic for General Internal Medicine, Lindenhofspital Bern, 3012 Bern, Switzerland
Hamacher, Jürg

Objective : Current treatments for blast-induced lung injury are limited to supportive procedures including mechanical ventilation. The study aimed to investigate the role of post-trauma-induced oedema generation in the function of time and trauma intensity and the probable role of beta 2-adrenergic receptors (β 2 -ARs) agonists on pulmonary oedema. The study is conducted using an ex vivo model after an experimental in vivo blast-induced thorax trauma in rats. Methods : Rats were randomised and divided into two groups, blast and sham. The blast group were anaesthetised and exposed to the blast wave (3.16 ± 0.43 bar) at a distance of 3.5 cm from the thorax level. The rats were sacrificed 10 min after the blast, the lungs explanted and treated with terbutaline, formoterol, propranolol or amiloride to assess the involvement of sodium transport. Other groups of rats were exposed to distances of 5 and 7 cm from the thorax to reduce the intensity of the injury. Further, one group of rats was studied after 180 min and one after 360 min after a 3.5 cm blast injury. Sham controls were exposed to identical procedures except for receiving blast overpressure. Results : Lung injury and oedema generation depended on time after injury and injury intensity. Perfusion with amiloride resulted in a further increase in oedema formation as indicated by weight gain ( p < 0.001), diminished tidal volume (Tv) ( p < 0.001), and increased airway resistance ( p < 0.001). Formoterol caused a significant increase in the Tv ( p < 0.001) and a significant decrease in the airway resistance ( p < 0.01), while the lung weight was not influenced. Trauma-related oedema was significantly reduced by terbutaline in terms of lung weight gain ( p < 0.01), Tv ( p < 0.001), and airway resistance ( p < 0.01) compared to control blast-injured lungs. Terbutaline-induced effects were completely blocked by the β-receptor antagonist propranolol ( p < 0.05). Similarly, amiloride, which was added to terbutaline perfusion, reversed terbutaline-induced weight gain reduction ( p < 0.05). Conclusions : β 2 -adrenoceptor stimulation had a beneficial impact by amiloride-dependent sodium and therefore, fluid transport mechanisms on the short-term ex vivo oedema generation in a trauma-induced in vivo lung injury of rats.

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