Effect of adjunct treatments on end-organ damage and histological injury severity in acute respiratory destress syndrome and multiorgan failure caused by smoke inhalation injury (SII) and burns

Abstract Background We investigated effects of mesenchymal stem cells (MSC) or low-flow extracorporeal life support (ECLS) as forms of adjunct treatment for acute respiratory destress syndrome (ARDS) due to smoke inhalation injury (SII) and 40% TBSA burns by assessing their effects on histological injury scores. We hypothesized that adjunct treatments decrease histological end-organ damage. Methods Anesthetized female swine: CTR (no injury, n = 4), ICTR (injured untreated, n = 10), Allo (injured treated with allogenic mesenchymal stem cells [MSC], n = 10), Auto (injured treated with autologous MSC, n = 10), Hemo (injured and treated with the Hemolung low flow ECLS system, n = 9), and Nova (injured and treated with the NovaLung low flow ECLS system, n = 8), Scores from lung, kidneys, liver, and jejunum were calculated, as was a total sum of all scores per organ. Data are presented as mean ± SEM. Results All CTR animals lived for 72 h with trivial management requirements. Survival was: 100% in CTR; 40% in ICTR; 33.3% in Hemo; 62.5% in Nova; 50% in Allo and 90% in Auto. ARDS developed in: 10/10 INCTR; 8/9 Hemo; 5/8 Nova; 9/10 Allo and 6/10 Auto. MSC groups had significantly lower diffuse alveolar damage (DAD) scores than ICTR animals (Allo, 26.6 ± 3.4 and Auto, 18.9 ± 1.5 vs. INJ, 46.8 ± 2.1, p  Conclusion DAD was associated with PFR