Immunologische Reaktionen auf ein Inhalationstrauma in Kombination mit einer Verbrennung : Etablierung eines standardisierten Tiermodells unter besonderer Berücksichtigung des intraalveolären Interleukin-6

摘要

In daily clinical routine the combination of inhalation and burn trauma is often to be found with fire victims. The mortality of such a combined trauma is higher than those of the single injuries. The pathophysiologic and immunologic pathways that lead to this increased mortality are not yet fully revealed. Therefore experimental animal models are needed to examine those post traumatic reactions in a living organism. In the first part of this work we have succeeded in setting up a standardized small animal model to examine inhalation and burn trauma in the rat. This model stands out due to its high standardization of the added traumas as well as its good ability for reproduction. The animal model developed in the course of this work is thereby recommended for further use in future studies. The second part of this work examined the immunologic effects of the combined trauma under special consideration of the intraalveolar interleukin-6 concentration. Within the control group it was possible to observe a significant increase of the intraalveolar interleukin-6 concentration after physiological respirator therapy alone. In comparison to the other test groups the control group showed the highest IL-6 concentrations throughout our observations. The single inhalation and burn trauma produced no statistically significant trend of the measured IL-6 concentrations during the first 6 hours post trauma. After combined burn and inhalation injury we were also not able to show statistically significant results, nevertheless our data revealed a trend that this combined trauma leads to an increased intraalveolar IL-6 excretion. Since these results of the second part of our studies do not allow a closer conclusion on the immunologic pathways after combined inhalation and thermal trauma, we suggest further validation of our findings in a similar experimental setting using small animals like the rat. Therefore future studies should incorporate other immunologic mediators and cytokines, because the increased mortality after a combined inhalation and burn trauma is not explainable by monitoring a single factor of this complex chain reaction.