Up in Smoke

Surprise from Smoke Inhalation Study

(RxWiki News) In life, expect the unexpected. In science, expect the unexpected.

In a morbidity and mortality study with burn patients, contrary to expectations, patients who died from their burns had a lower inflammatory response in their lungs than patients who survived.

DailyRx Insight:  Understanding early pulmonary immune dysfunction may allow improved therapies to produce better outcomes in burn care.

First author of the study is Christopher S. Davis, MD, a general surgery resident at Loyola University Hospital Researchers and his colleagues  followed 60 burn patients at the Loyola University Hospital Burn Center, whose  severity of inhalation injury was categorized into one of five grades (0, 1, 2, 3, and 4). Zero equals the absence of visible injury.

As expected, patients with the worst combined burn-and-smoke-inhalation injuries required more time on the ventilator, as well as the intensive care unit. Their hospital stay was also longer as was their likelihood of death. 

In this study, it was the  immune system findings that  were unexpected. Researchers measured concentrations of 28 immune system modulators, which are proteins produced by white blood cells which sometimes recruit leukocytes to areas of tissue damage or activate them to begin the repair process that follows tissue injury.

Based on previous studies, researchers had expected to find higher concentrations of modulators in patients who died, as sicker patients usually  have more active inflammatory responses. However, researchers found just the opposite: patients who died had lower concentrations of these modulators in their lungs.  It appears that the inflammatory and immune response to injury remains incompletely understood and requires additional studies.

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