Nebulized hypertonic saline attenuates acute lung injury following trauma and hemorrhagic shock via inhibition of matrix metalloproteinase-13*

• DOI: 10.1097/ccm.0b013e3182592006
• Publication Date: 2012-06-23T06:51:08Z
• Authors: Max Wohlauer; Ernest E. Moore; Christopher C. Si...; Miguel Fragoso; Fabia Gamboni; Jeffrey Harr; Frank Accurso; Frank Wright; James Haenel; David Fullerton; Anirban Banerjee
• Keywords: Hypertonic saline; Hemorrhagic shock; Matrix metalloproteinase 9

Objective: We hypothesized that aerosolized inhaled hypertonic saline given at the onset of resuscitation will decrease acute lung injury following hemorrhagic shock, by inhibiting release epithelial derived proinflammatory mediators. Design: Animal study. Setting: Animal-care facility procedure room in a medical center. Subjects: Adult male Sprague-Dawley rats. Interventions: Rats underwent shock followed 2 hrs and 1 hr observation. In study group, nebulized was delivered end period after resuscitation. Measurements Main Results: Shock provoked injury, which attenuated with (1.56 ± 0.2 mg protein/mL vs. 0.95 0.3 bronchoalveolar lavage fluid, + saline, p < .01). Nebulized reduced inflammation (cytokine-induced neutrophil chemoattractant-1 accumulation fluid 5999 1267 pg/mL 3342 859 pg/mL, = .006). Additionally, inhibited matrix ­metalloproteinase-13 (1513 337 230 19 .009) pretreatment metalloproteinase-13 inhibitor sufficient to attenuate postshock (1.42 0.09 mg/mL 0.77 0.23 protein, CL-82198, .002). Conclusion: Inhaled attenuates exerting an anti-inflammatory effect on pulmonary epithelium, suggesting new clinical strategy treat injury/acute respiratory distress syndrome.