Effect of denervation of a lung on pulmonary platelet trapping associated with traumatic shock
Thörne, L.J.; Kuenzig, M.; Homeira, B.S.; McDonald, H.M.; Schwartz, S.I.
Surgery 88(2): 208-214
1980
ISSN/ISBN: 0039-6060 PMID: 7394703 Document Number: 168407
Lung denervation reduces pulmonary platelet trapping (PPT) associated with neurogenic pulmonary edema. The universality of the role of pulmonary innervation in PPT associated with shock induced by soft tissue trauma and by endotoxin injection was investigated. The left lungs of dogs were denervated by autotransplantation 2 mo. prior to induction of shock. Autologous platelets were labeled with 51Cr and reinfused the day prior to shock induced by blunt trauma to the hind limbs or by injection of endotoxin. The animals were killed after 2-4 h of shock. Coded specimens of each lung were evaluated by light microscopy and EM. The remaining part of the lung was dried and counted for 51Cr activity as a measure of PPT. Increased platelet aggregability was noted in all shocked animals. Hypotension induced by trauma was associated with increased PPT in the innervated lungs compared with the sham controls. There was no significant difference in PPT between the denervated lungs of these animals and the sham controls. The increase in PPT in innervated lungs was greater in the endotoxin model. Although a small increase in PPT was demonstrated in the denervated lungs of endotoxin shocked animals, this was appreciably less than noted in the contralateral innervated lungs. Light microscopy showed a lesser degree of intravascular thrombosis and EM, identified fewer platelets and less aggregation in the denervated lungs compared to the contralateral innervated lungs. Local neurogenic stimuli affect PPT associated with shock due to a variety of causes. Drugs which reduce nerve traffic to the lung may be indicated as therapy.