436 Bums (1991) 17, (5), 436-437 Printed in Great Britain

Abstracts

CLINICAL STUDIES

Lung function studies following smoke inhalation During the period between the first 3 days after smoke inhalation and 3 months later, lung function studies showed that the initial airways hyperreactivity improved but FEV and airways specific conductance did not change significantly. There was a strong correlation between carboxyhaemoglobin concentrations soon after injury and the initial airways specific conductance. Early lung function studies are recommended since airways obstruction following inhalation of house fire smoke may be both more common and more persistent than is generally recognized.

Kinsella J., Carter R., Reid W. H. et al. (1991) Increased airways reactivity after smoke inhalation. Lancet 337, 595-597.

Early hyperglycaemia in burned children In 14 out of 31 children with bums of varying severity the blood glucose level rose to a peak of between 10 and 20 mmol/l within 4 h of injury; by 4-8 h after injury the peak had fallen to between 5 and 10 mmol/1. The peak value usually preceded treatment and the fall occurred during the infusion of dextrose saline. The peak concentrations were independent of bum severity. Unexpectedly the hyperglycaemia was poorly related to contemporary adrena- line concentrations. Insulin resistance probably developed within the first 2 h after injury.

Childs C., Heath D. F., Little R. A. et al. (1990) Glucose metabolism in children during the first day after bum injury. Arch. Emerg. Med. 7, (3), 135-147.

IL-6 and acute-phase proteins Studies of the relationship between IL-6 and the serum concentra- tions of alpha-1 acid glycoprotein and alpha-1 protease inhibitor in sera from burned patients showed raised levels of IL-6 during the days following injury with a peak at 4 or 5 days. The serum concentrations of alpha-1 acid glycoprotein and alpha-1 protease inhibitor reached their maximal values after day 5 and remained at a high level for the following 6 weeks at least. The reactivities of these acute-phase proteins to concanavalin A were raised during the first 16 days postinjury and the changes in concentration of the acute-phase proteins mirrored the changes in the serum contents of IL-6. The affinity for concanavalin A rapidly declined long before there were measured decreases in the levels of the acute-phase proteins in serum.

Pos O., van der Stelt M. E., Wolbink G. J. et al. (1990) Changes in the serum concentration and the glycosylation of human alpha 1 acid glycoprotein and alpha 1 protease inhibitor in severely burned persons in relation to interleukin 6 levels. Clin. Exp. Immunol. 82, (3), 579-582.

ANIMAL STUDIES

Drug-induced changes in metabolism In a controlled study in rats with deep burns the use of clenbuteroL a selective beta-2 adrenergic agonist, induced an increase in resting energy expenditure (REE) and normalized body weight gain, muscle mass and muscle protein content compared with the findings in untreated rats with bums. However the use of nadolol, a long-acting beta adrenergic antagonist in other burned rats,

�9 1991 Butterworth-Heinemann Ltd 0305-4179/91/050436-02

reduced muscle mass while having no effect on REE, body weight gain or muscle protein content.

Chance W. T., yon Allmen D., Benson D. et al. (1991) Clenbuterol decreases catabolism and increases hypermetabolism in burned rats. ]. Trauma 31, (3), 365-370.

Deferoxamine prevents oxidant injury Eighteen sheep with deep extensive (40 per cent TBSA) bums were resuscitated with Ringer's lactate or its admixture with hetastarch alone or hetastarch plus deferoxamine. The sheep resuscitated with Ringer's lactate or its admixture with hetastarch alone showed significant lung inflammation and significant increases in lung and liver malondialdehyde. The group resusci- tated with hetastarch alone required 15 per cent less fluid, resuscitation with hetastarch plus deferoxamine decreased the total fluid needs by 30 per cent and prevented the increase in lung and liver malondialdehyde levels. However bum tissue oedema, measured as protein-rich lymph flow, was significantly increased by use of deferoxamine possibly related to increased perfusion of bum tissues.

Demling R., Lalonde C., Knox J. et al. (1991) Fluid resuscitation with deferoxamine prevents systemic bum-induced oxidant injury. J. Trauma 31, (4), 538--544.

LABORATORY STUDIES

Beneficial effects of granulocyte colony stimulating factor Administration of recombinant granulocyte colony stimulating factor increased neutrophil chemotaxis from the subnormal values found in untreated burned mice to the levels found in normal animals. Bum wound infection did not modify the beneficial effects of the stimulatory factor, the latter appeared to be due to a combination of increased numbers of myeloid elements and a preservation of their function.

Sartorelli K. H., Silver G. M. and Gamelli R. L. (1991) The effect of granulocyte colony stimulating factor (G-CSF) upon bum- induced defective neutrophil chemotaxis. ]. Trauma 31, (4), 523-530.

Products in granulation tissue impair keratinocyte growth The proliferation of human keratinocytes in tissue culture, using SH-thymidine incorporation into cellular DNA, was assessed after the culture medium had been exposed to either granulation tissue or normal tissue. There was marked inhibition of keratinocyte growth in the presence of medium exposed to granulation tissue, attributed to the presence in the medium of fibrin or products derived during the conversion of fibrinogen to fibrin.

Shakespeare V. and Shakespeare P. G, (1991) Effects of granulation tissue conditioned medium on the growth of human keratinocytes in vitro. Br. J. PlasL Surg. 44, (3), 219-223.

Effective donor skin preparation In the preparation of allograft skin from cadaver donors, the addition of 4 per cent chlorhexidine gluconate to the usual cleansing mixture of poviflone iodine, detergent and 70 per cent