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Exposure to 100% Oxygen Abolishes the Impairment of Fracture Healing after Thoracic Trauma.

Kemmler J, Bindl R, McCook O, Wagner F, Gröger M, Wagner K, Scheuerle A, Radermacher P, Ignatius A - PLoS ONE (2015)

Bottom Line: Inflammatory cytokines and markers of oxidative/nitrosative stress were measured in plasma, lung and fracture hematoma.Short-term exposure to 100% oxygen in the acute post-traumatic phase significantly attenuated systemic and local inflammatory responses and improved fracture healing without provoking toxic side effects, suggesting that hyperoxia could induce anti-inflammatory and pro-regenerative effects after severe injury.These results suggest that breathing of 100% oxygen in the acute post-traumatic phase might reduce the risk of poorly healing fractures in severely injured patients.

View Article: PubMed Central - PubMed

Affiliation: Institute of Orthopaedic Research and Biomechanics, Center of Musculoskeletal Research, University of Ulm, Ulm, Germany.

ABSTRACT
In polytrauma patients a thoracic trauma is one of the most critical injuries and an important trigger of post-traumatic inflammation. About 50% of patients with thoracic trauma are additionally affected by bone fractures. The risk for fracture malunion is considerably increased in such patients, the pathomechanisms being poorly understood. Thoracic trauma causes regional alveolar hypoxia and, subsequently, hypoxemia, which in turn triggers local and systemic inflammation. Therefore, we aimed to unravel the role of oxygen in impaired bone regeneration after thoracic trauma. We hypothesized that short-term breathing of 100% oxygen in the early post-traumatic phase ameliorates inflammation and improves bone regeneration. Mice underwent a femur osteotomy alone or combined with blunt chest trauma 100% oxygen was administered immediately after trauma for two separate 3 hour intervals. Arterial blood gas tensions, microcirculatory perfusion and oxygenation were assessed at 3, 9 and 24 hours after injury. Inflammatory cytokines and markers of oxidative/nitrosative stress were measured in plasma, lung and fracture hematoma. Bone healing was assessed on day 7, 14 and 21. Thoracic trauma induced pulmonary and systemic inflammation and impaired bone healing. Short-term exposure to 100% oxygen in the acute post-traumatic phase significantly attenuated systemic and local inflammatory responses and improved fracture healing without provoking toxic side effects, suggesting that hyperoxia could induce anti-inflammatory and pro-regenerative effects after severe injury. These results suggest that breathing of 100% oxygen in the acute post-traumatic phase might reduce the risk of poorly healing fractures in severely injured patients.

No MeSH data available.


Related in: MedlinePlus

Biomechanical and μCT analysis of the fracture callus 21 days post-injury.(A-C) The binding stiffness, moment of inertia and the apparent Young’s modulus of the fracture callus were decreased following TXT, O2 treatment abolished these effects. Data represent medians and quartiles. Specimen numbers for each group are depicted. *p<0.05, **p < 0.001.
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pone.0131194.g002: Biomechanical and μCT analysis of the fracture callus 21 days post-injury.(A-C) The binding stiffness, moment of inertia and the apparent Young’s modulus of the fracture callus were decreased following TXT, O2 treatment abolished these effects. Data represent medians and quartiles. Specimen numbers for each group are depicted. *p<0.05, **p < 0.001.

Mentions: Fracture healing was evaluated by biomechanical testing, μCT and histomorphometrical analyses. Comparing the two groups under normoxia, the bending stiffness, moment of inertia and apparent Young’s modulus of the fractured femurs were significantly reduced by the additional thoracic trauma (-46%; p = 0.001; -33%, p = 0.032; and -43%, p = 0.021; respectively) indicating a smaller callus with poor mechanical competence (Fig 2A–2C). μCT analysis of BV/TV did not show group differences (data not shown).


Exposure to 100% Oxygen Abolishes the Impairment of Fracture Healing after Thoracic Trauma.

Kemmler J, Bindl R, McCook O, Wagner F, Gröger M, Wagner K, Scheuerle A, Radermacher P, Ignatius A - PLoS ONE (2015)

Biomechanical and μCT analysis of the fracture callus 21 days post-injury.(A-C) The binding stiffness, moment of inertia and the apparent Young’s modulus of the fracture callus were decreased following TXT, O2 treatment abolished these effects. Data represent medians and quartiles. Specimen numbers for each group are depicted. *p<0.05, **p < 0.001.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4492600&req=5

pone.0131194.g002: Biomechanical and μCT analysis of the fracture callus 21 days post-injury.(A-C) The binding stiffness, moment of inertia and the apparent Young’s modulus of the fracture callus were decreased following TXT, O2 treatment abolished these effects. Data represent medians and quartiles. Specimen numbers for each group are depicted. *p<0.05, **p < 0.001.
Mentions: Fracture healing was evaluated by biomechanical testing, μCT and histomorphometrical analyses. Comparing the two groups under normoxia, the bending stiffness, moment of inertia and apparent Young’s modulus of the fractured femurs were significantly reduced by the additional thoracic trauma (-46%; p = 0.001; -33%, p = 0.032; and -43%, p = 0.021; respectively) indicating a smaller callus with poor mechanical competence (Fig 2A–2C). μCT analysis of BV/TV did not show group differences (data not shown).

Bottom Line: Inflammatory cytokines and markers of oxidative/nitrosative stress were measured in plasma, lung and fracture hematoma.Short-term exposure to 100% oxygen in the acute post-traumatic phase significantly attenuated systemic and local inflammatory responses and improved fracture healing without provoking toxic side effects, suggesting that hyperoxia could induce anti-inflammatory and pro-regenerative effects after severe injury.These results suggest that breathing of 100% oxygen in the acute post-traumatic phase might reduce the risk of poorly healing fractures in severely injured patients.

View Article: PubMed Central - PubMed

Affiliation: Institute of Orthopaedic Research and Biomechanics, Center of Musculoskeletal Research, University of Ulm, Ulm, Germany.

ABSTRACT
In polytrauma patients a thoracic trauma is one of the most critical injuries and an important trigger of post-traumatic inflammation. About 50% of patients with thoracic trauma are additionally affected by bone fractures. The risk for fracture malunion is considerably increased in such patients, the pathomechanisms being poorly understood. Thoracic trauma causes regional alveolar hypoxia and, subsequently, hypoxemia, which in turn triggers local and systemic inflammation. Therefore, we aimed to unravel the role of oxygen in impaired bone regeneration after thoracic trauma. We hypothesized that short-term breathing of 100% oxygen in the early post-traumatic phase ameliorates inflammation and improves bone regeneration. Mice underwent a femur osteotomy alone or combined with blunt chest trauma 100% oxygen was administered immediately after trauma for two separate 3 hour intervals. Arterial blood gas tensions, microcirculatory perfusion and oxygenation were assessed at 3, 9 and 24 hours after injury. Inflammatory cytokines and markers of oxidative/nitrosative stress were measured in plasma, lung and fracture hematoma. Bone healing was assessed on day 7, 14 and 21. Thoracic trauma induced pulmonary and systemic inflammation and impaired bone healing. Short-term exposure to 100% oxygen in the acute post-traumatic phase significantly attenuated systemic and local inflammatory responses and improved fracture healing without provoking toxic side effects, suggesting that hyperoxia could induce anti-inflammatory and pro-regenerative effects after severe injury. These results suggest that breathing of 100% oxygen in the acute post-traumatic phase might reduce the risk of poorly healing fractures in severely injured patients.

No MeSH data available.


Related in: MedlinePlus