Reaming of femoral fractures with different reaming irrigator aspirator systems shows distinct effects on cardiac function after experimental polytrauma.
cardiac ventricular outthrow
complement system
inflammation
left ventricular end-diastolic pressure
transesophageal echocardiography
Journal
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
ISSN: 1554-527X
Titre abrégé: J Orthop Res
Pays: United States
ID NLM: 8404726
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
22
06
2020
revised:
11
08
2020
accepted:
18
08
2020
pubmed:
23
8
2020
medline:
3
2
2021
entrez:
23
8
2020
Statut:
ppublish
Résumé
Cardiac injuries are recorded after multiple trauma and are associated with a poor patient outcome. Reaming prior to locked intramedullary nailing is a frequently used technique to stabilize femoral diaphysis fractures. However, in polytraumatized patients, complications such as fat emboli and acute respiratory distress syndrome have been associated with reaming. The reaming irrigator aspirator (RIA) system provides concomitant irrigation and suction of the intramedullary contents, and should, therefore, reduce reaming-associated complications. The aim of the study was to investigate cardiac function after multiple trauma with regard to two different RIA devices (RIAI vs RIAII). 15 male pigs were included in the study. Pigs received either sham treatment or multiple trauma (chest trauma, femur fracture, liver laceration, and hemorrhagic shock), followed by intramedullary nailing after reaming with either the RIAI or RIAII system (RIAII: reduced diameter of the reamer, improved control of irrigation and suction). Cardiac function was assessed by transesophageal echocardiography and systemic inflammation as well as local cardiac damage examined. Pigs of both treatment groups showed impaired cardiac function, valvular insufficiency, and cardiac damage. Systemic inflammation and local cardiac alterations were observed which might contribute to early myocardial damage in vivo. Multiple trauma including long-bone fracture and subsequent intramedullary reaming induces cardiac dysfunction and valvular insufficiency, which might be linked to both mechanical cardiac injury and increased systemic inflammation. 6 hours after trauma there are less differences between RIAI and RIAII treatment with regard to post-traumatic cardiac consequences in multiple injured pigs, indicating no beneficial effect of RIAII over RIAI.
Substances chimiques
Alarmins
0
Biomarkers
0
Fatty Acid Binding Protein 3
0
Troponin I
0
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2608-2618Informations de copyright
© 2020 The Authors. Journal of Orthopaedic Research® published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.
Références
Crown LA, Hawkins W. Commotio cordis: clinical implications of blunt cardiac trauma. Am Fam Physician. 1997;55:2467-2470.
Nirgiotis JG, Colon R, Sweeney MS. Blunt trauma to the heart: the pathophysiology of injury. J Emerg Med. 1990;8:617-623.
Huber S, Biberthaler P, Delhey P, et al. Predictors of poor outcomes after significant chest trauma in multiply injured patients: a retrospective analysis from the German Trauma Registry (Trauma Register DGU(R)). Scand J Trauma Resusc Emerg Med. 2014;22:52.
Skinner DL, Laing GL, Rodseth RN, Ryan L, Hardcastle TC, Muckart DJ. Blunt cardiac injury in critically ill trauma patients: a single centre experience. Injury. 2015;46:66-70.
Kalbitz M, Schwarz S, Weber B, et al. Cardiac depression in pigs after multiple trauma-characterization of posttraumatic structural and functional alterations. Sci Rep. 2017;7:17861.
Abrams ST, Zhang N, Manson J, et al. Circulating histones are mediators of trauma-associated lung injury. Am J Respir Crit Care Med. 2013;187:160-169.
Kalbitz M, Fattahi F, Herron TJ, et al. Complement destabilizes cardiomyocyte function in vivo after polymicrobial sepsis and in vitro. J Immunol. 2016;197:2353-2361.
Lackner I, Weber B, Baur M, et al. Midkine is elevated after multiple trauma and acts directly on human cardiomyocytes by altering their functionality and metabolism. Front Immunol. 2019;10:1920.
Pape HC, Halvachizadeh S, Leenen L, Velmahos GD, Buckley R, Giannoudis PV. Timing of major fracture care in polytrauma patients - An update on principles, parameters and strategies for 2020. Injury. 2019;50:1656-1670.
Giannoudis PV, Tan HB, Perry S, Tzioupis C, Kanakaris NK. The systemic inflammatory response following femoral canal reaming using the reamer-irrigator-aspirator (RIA) device. Injury. 2010;41(suppl 2):S57-S61.
Society COT. Nonunion following intramedullary nailing of the femur with and without reaming. Results of a multicenter randomized clinical trial. J Bone Joint Surg Am. 2003;85:2093-2096.
Matthews SJ, Nikolaou VS, Giannoudis PV. Innovations in osteosynthesis and fracture care. Injury. 2008;39:827-838.
Giannoudis PV, Smith RM, Bellamy MC, Morrison JF, Dickson RA, Guillou PJ. Stimulation of the inflammatory system by reamed and unreamed nailing of femoral fractures. An analysis of the second hit. J Bone Joint Surg Br. 1999;81:356-361.
Giannoudis PV. Current concepts of the inflammatory response after major trauma: an update. Injury. 2003;34:397-404.
Husebye EE, Lyberg T, Opdahl H, Laurvik H, Røise O. Cardiopulmonary response to reamed intramedullary nailing of the femur comparing traditional reaming with a one-step reamer-irrigator-aspirator reaming system: an experimental study in pigs. J Trauma. 2010;69:E6-E14.
Husebye EE, Opdahl H, Røise O, Aspelin T, Lyberg T. Coagulation, fibrinolysis and cytokine responses to intramedullary nailing of the femur: an experimental study in pigs comparing traditional reaming and reaming with a one-step reamer-irrigator-aspirator system. Injury. 2011;42:630-637.
Giannoudis PV, Tzioupis C, Green J. Surgical techniques: how I do it? The reamer/irrigator/aspirator (RIA) system. Injury. 2009;40:1231-1236.
Pape HC, Zelle BA, Hildebrand F, Giannoudis PV, Krettek C, van Griensven M. Reamed femoral nailing in sheep: does irrigation and aspiration of intramedullary contents alter the systemic response? J Bone Joint Surg. 2005;87:2515-2522.
Van Gorp CC, Falk JV, Kmiec SJ Jr, Siston RA Jr. The reamer/irrigator/aspirator reduces femoral canal pressure in simulated TKA. Clin Orthop Relat Res. 2009;467:805-809.
Horst K, Simon TP, Pfeifer R, et al. Characterization of blunt chest trauma in a long-term porcine model of severe multiple trauma. Sci Rep. 2016;6:39659.
Horst K, Eschbach D, Pfeifer R, et al. Local inflammation in fracture hematoma: results from a combined trauma model in pigs. Mediators Inflamm. 2015;2015:126060.
Leite-Moreira AF, Lourenço AP, Roncon-Albuquerque R Jr, et al. Diastolic tolerance to systolic pressures closely reflects systolic performance in patients with coronary heart disease. Basic Res Cardiol. 2012;107:251.
Lackner I, Weber B, Baur M, et al. Complement activation and organ damage after trauma-differential immune response based on surgical treatment strategy. Front Immunol. 2020;11:11.
Claycomb WC, Lanson NA Jr Jr., Stallworth BS, et al. HL-1 cells: a cardiac muscle cell line that contracts and retains phenotypic characteristics of the adult cardiomyocyte. Proc Natl Acad Sci U S A. 1998;95:2979-2984.
Bruijns SR, Guly HR, Bouamra O, Lecky F, Lee WA. The value of traditional vital signs, shock index, and age-based markers in predicting trauma mortality. J Trauma Acute Care Surg. 2013;74:1432-1437.
Toccaceli A, Giampaoletti A, Dignani L, Lucertini C, Petrucci C, Lancia L. The role of shock index as a predictor of multiple-trauma patients' pathways. Nurs Crit Care. 2016;21:e12-e19.
Berger D, Takala J. Determinants of systemic venous return and the impact of positive pressure ventilation. Ann Transl Med. 2018;6:350.
Saric P, Ravaee BD, Patel TR, Hoit BD. Acute severe mitral regurgitation after blunt chest trauma. Echocardiography. 2018;35:272-274.
Hasdemir H, Arslan Y, Alper A, et al. Severe tricuspid regurgitation and atrioventicular block caused by blunt thoracic trauma in an elderly woman. J Emerg Med. 2012;43:445-447.
Karaca O, Demir G, Özyüksel A, Akçevin A. Tricuspid valve chordal rupture after a motorbike accident. Turk Kardiyoloji Dernegi Arsivi: Turk Kardiyoloji Derneginin yayin organidir. 2016;44:329-331.
Marcolini EG, Keegan J. Blunt cardiac injury. Emerg Med Clin North Am. 2015;33:519-527.
Naganathar S, De'Ath HD, Wall J, Brohi K. Admission biomarkers of trauma-induced secondary cardiac injury predict adverse cardiac events and are associated with plasma catecholamine levels. J Trauma Acute Care Surg. 2015;79:71-77.
Kalbitz M, Pressmar J, Stecher J, et al. The role of troponin in blunt cardiac injury after multiple trauma in humans. World J Surg. 2017;41:162-169.
Kalbitz M, Grailer JJ, Fattahi F, et al. Role of extracellular histones in the cardiomyopathy of sepsis. FASEB J. 2015;29:2185-2193.
Alhamdi Y, Abrams ST, Cheng Z, et al. Circulating histones are major mediators of cardiac injury in patients with sepsis. Crit Care Med. 2015;43:2094-2103.
Cheng Z, Abrams ST, Alhamdi Y, et al. Circulating histones are major mediators of multiple organ dysfunction syndrome in acute critical illnesses. Crit Care Med. 2019;47:e677-e684.
Mair J, Lindahl B, Hammarsten O, et al. The European Society of Cardiology (ESC), The Acute Cardiovascular Care Association (ACCA). How is cardiac troponin released from injured myocardium. Eur Heart J. 2017.
Tao L, Liu HR, Gao F, et al. Mechanical traumatic injury without circulatory shock causes cardiomyocyte apoptosis: role of reactive nitrogen and reactive oxygen species. Am J Physiol Heart Circ Physiol. 2005;288:H2811-H2818.
Burk A-M, Martin M, Flierl MA, et al. Early complementopathy after multiple injuries in humans. Shock. 2012;37:384-354.
Hoesel LM, Niederbichler AD, Schaefer J, et al. C5a-blockade improves burn-induced cardiac dysfunction. J Immunol. 2007;178:7902-7910.
Lackner I, Weber B, Knecht D, et al. Cardiac glucose and fatty acid transport after experimental mono- and polytrauma. Shock. 2019;53:620-629.
Hill J, McLean M, Gothard D. The glucose connection: field hyperglycemia as an early predictor of hypotension in trauma patients. Air Med J. 2019;38:325-326.
Levy RJ, Piel DA, Acton PD, et al. Evidence of myocardial hibernation in the septic heart. Crit Care Med. 2005;33:2752-2756.
Armstrong DD, Esser KA. Wnt/beta-catenin signaling activates growth-control genes during overload-induced skeletal muscle hypertrophy. Am J Physiol: Cell Physiol. 2005;289:C853-C859.
Zelarayan L, Gehrke C, Bergmann MW. Role of beta-catenin in adult cardiac remodeling. Cell Cycle. 2007;6:2120-2126.
Lin JC, Kuo WW, Baskaran R, et al. Enhancement of beta-catenin in cardiomyocytes suppresses survival protein expression but promotes apoptosis and fibrosis. Cardiol J. 2017;24:195-205.
Deb A. Cell-cell interaction in the heart via Wnt/beta-catenin pathway after cardiac injury. Cardiovasc Res. 2014;102(2):214-223.