Abstract
ObjectiveTo develop a clinically relevant model of severe acute respiratory distress syndrome (ARDS) in swine with the aim to test therapeutic interventions.MethodsUnder intravenous anesthesia (ketamine, midazolam), female swine (44.8 ± 1.9kg) underwent tracheostomy, line placement, exposure to 30L of smoke, and a 40% total body surface area full‐thickness flame burn. Animals were monitored for 7 days with one‐on‐one ICU care. Post burn resuscitation using lactated Ringer's was guided by a computerized algorithm. At onset of ARDS [PaO2:FiO2 ratio (PFR) < 200], the injury group (IG, n=5) received low‐tidal volume ventilation per ARDSNet guidelines. Time controls (TC, n=2) were uninjured. Data are means; statistics by T‐test or Wilcoxon 2‐sample test.ResultsPost‐injury carboxyhemoglobin level in IG was 89.8 ± 1.4% with onset of ARDS at 22 ± 1.7 hrs post‐injury. Survival time was lower in IG (65 ± 14 hrs) compared with TC (168 hrs, p<0.0001). Peak airway pressure in IG increased above 30cm H2O 6 hrs after injury (p<0.02). PFR in IG decreased below 200 at 24hr post‐injury (p<0.01) and remained lower than TC until the end of study.ConclusionsWe have created a clinically relevant porcine model of ARDS within 24 hrs of smoke and thermal injuries. Future work includes validation of various interventions for ARDS management.Source of support: U.S. Army Institute of Surgical Research
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