Alcohol potentiates postburn remote organ damage through shifts in fluid compartments mediated by bradykinin

Shock. 2015 Jan;43(1):80-4. doi: 10.1097/SHK.0000000000000265.

Abstract

Of the 450,000 burn patients each year, 50% have a positive blood alcohol content, and this predisposes them to worsened clinical outcomes. Despite high prevalence and established consequences, the mechanisms responsible for alcohol-mediated complications of postburn remote organ damage are currently unknown. To this end, mice received a single dose of alcohol (1.12 g/kg) or water by oral gavage and were subjected to a 15% total body surface area burn. Animals with a burn alone lost ∼5% of their body weight in 24 h, whereas intoxicated and burned mice lost only 1% body weight (P < 0.05) despite a 17% increase in hematocrit (P < 0.05) and a 57% increase in serum creatinine (P < 0.05) over burn injury alone. This retention of water weight despite increased dehydration suggests that intoxication at the time of a burn causes a shift in fluid compartments that may exacerbate end-organ ischemia and damage as evidenced by a 3-fold increase in intestinal bacterial translocation (P < 0.05), a 30% increase (P < 0.05) in liver weight-to-body weight ratio, and an increase in alveolar wall thickness over a burn alone. Furthermore, administration of the bradykinin antagonist HOE140 30 min after intoxication and burn restored fluid balance and alleviated end-organ damage. These findings suggest that alcohol potentiates postburn remote organ damage through shifts in fluid compartments mediated by bradykinin.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bacterial Translocation / drug effects
  • Bradykinin / analogs & derivatives*
  • Bradykinin / antagonists & inhibitors*
  • Bradykinin / blood
  • Bradykinin / pharmacology
  • Bradykinin B2 Receptor Antagonists / pharmacology*
  • Burns* / blood
  • Burns* / complications
  • Burns* / drug therapy
  • Central Nervous System Depressants / adverse effects*
  • Central Nervous System Depressants / pharmacology
  • Creatinine / blood
  • Dehydration* / blood
  • Dehydration* / drug therapy
  • Dehydration* / etiology
  • Ethanol / adverse effects*
  • Ethanol / pharmacology
  • Hematocrit
  • Humans
  • Ischemia* / blood
  • Ischemia* / drug therapy
  • Ischemia* / etiology
  • Male
  • Mice

Substances

  • Bradykinin B2 Receptor Antagonists
  • Central Nervous System Depressants
  • Ethanol
  • icatibant
  • Creatinine
  • Bradykinin