Open Access

Klemens Horst, Tim-Philipp Simon, Roman Pfeifer, Michel Paul Johan Teuben, Khalid Almahmoud, Zhi Qiao, Susana Aguiar Santos, Carlos Emilio Castelar Wembers, Steffen Leonhardt, Nicole Heussen, Philipp Störmann, Birgit Auner, Borna Relja, Ingo Marzi, Alexander Tobias Haug, Martijn van Griensven, Miriam Kalbitz, Markus Huber-Lang, René H. Tolba, Lucy Kathleen Reiss, Stefan Uhlig, Gernot Marx, Hans-Christoph Pape, Frank Hildebrand

• Chest trauma has a significant relevance on outcome after severe trauma. Clinically, impaired lung function typically occurs within 72 hours after trauma. However, the underlying pathophysiological mechanisms are still not fully elucidated. Therefore, we aimed to establish an experimental long-term model to investigate physiological, morphologic and inflammatory changes, after severe trauma. Male pigs (sus scrofa) sustained severe trauma (including unilateral chest trauma, femur fracture, liver laceration and hemorrhagic shock). Additionally, non-injured animals served as sham controls. Chest trauma resulted in severe lung damage on both CT and histological analyses. Furthermore, severe inflammation with a systemic increase of IL-6 (p = 0.0305) and a local increase of IL-8 in BAL (p = 0.0009) was observed. The pO2/FiO2 ratio in trauma animals decreased over the observation period (p < 0.0001) but not in the sham group (p = 0.2967). Electrical Impedance Tomography (EIT) revealed differences between the traumatized and healthy lung (p < 0.0001). In conclusion, a clinically relevant, long-term model of blunt chest trauma with concomitant injuries has been developed. This reproducible model allows to examine local and systemic consequences of trauma and is valid for investigation of potential diagnostic or therapeutic options. In this context, EIT might represent a radiation-free method for bedside diagnostics.