Hypothermia does not influence liver damage and function in a porcine polytrauma model

Article type: Research Article

Authors: Eschbach, D.^{a; *} | Horst, K.^b | Sassen, M.^c | Andruszkow, J.^d | Mohr, J.^e | Debus, F.^a | Vogt, N.^f | Steinfeldt, T.^g | Hildebrand, F.^b | Schöller, K.^f | Uhl, E.^f | Wulf, H.^c | Ruchholtz, S.^a | Pape, H.^h | Frink, M.^a

Affiliations: [a] Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany | [b] Trauma Department, University of Aachen, Aachen, Germany | [c] Department of Anesthesiology and Critical Care, University Hospital Giessen and Marburg, Marburg, Germany | [d] Institute of Pathology, University of Aachen, Aachen, Germany | [e] Department of Trauma Surgery, University of Magdeburg, Magdeburg, Germany | [f] Department of Neurosurgery, University Hospital Giessen and Marburg, Giessen, Germany | [g] Department of Anesthesiology and Critical Care, Diakonie-Klinikum Schwäbisch Hall, Germany | [h] Department of Trauma, University of Zurich, Zurich, Switzerland

Correspondence: [*] Corresponding author: D. Eschbach, Center for Orthopaedics and Trauma Surgery, Baldingerstrasse 1, D-35043 Marburg, Germany. Tel.: +49 06421 586 3544; E-mail: [email protected];url:http://www.med.uni-marburg.de.

Abstract: BACKGROUND: Previous studies revealed evidence that induced hypothermia attenuates ischemic organ injuries after severe trauma. In the present study, the effect of hypothermia on liver damage was investigated in a porcine long term model of multi-system injury, consisting of blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shock METHODS: In 30 pigs, a standardized polytrauma including blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shock of 45% of total blood volume was induced. Following trauma, hypothermia of 33∘C was induced for 12 h and intensive care treatment was evaluated for 48 h. As outcome parameters, we assessed liver function and serum transaminase levels as well as a histopathological analysis of tissue samples. A further 10 animals served as controls. RESULTS: Serum transaminase levels were increased at the end of the observation period following hypothermia without reaching statistical significance compared to normothermic groups. Liver function was preserved (p⩽ 0.05) after the rewarming period in hypothermic animals but showed no difference at the end of the observation period. In H&E staining, cell death was slightly increased hypothermic animals and caspase-3 staining displayed tendency towards more apoptosis in hypothermic group as well. CONCLUSIONS: Induction of hypothermia could not significantly improve hepatic damage during the first 48 h following major trauma. Further studies focusing on multi-organ failure including a longer observation period are required to illuminate the impact of hypothermia on hepatic function in multiple trauma patients.

Keywords: Hypothermia, porcine animal model, trauma model, liver laceration

DOI: 10.3233/THC-171043

Journal: Technology and Health Care, vol. 26, no. 2, pp. 209-221, 2018