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Induced Hypothermia Preserves the Functional Enterocyte Mass in A Porcine Multiple Trauma Model: Retracted
Matthias Fröhlich1, Marc Maegele, Frank Hildebrand
1*Department of Orthopaedic Surgery, Traumatology and Sports Traumatology, Cologne-Merheim Medical Centre (CMMC), Witten/Herdecke University, Ostmerheimer Str. 200, D-51109 Cologne, Germany †IFOM - Institute for Research in Operative Medicine, Witten/Herdecke University, Germany ‡Department of Orthopaedic Trauma and Reconstructive Surgery, University Hospital Aachen, Germany §Department of Orthopaedic Trauma Surgery, University of Schleswig-Holstein, Kiel, Germany ¶Trauma Department, Hannover Medical School, Germany ||Department of Orthopaedic Trauma Surgery, University of Magdeburg, Germany #Department of Traumatology, Orthopaedic- and Hand-Surgery, Hospital Solingen, Germany **Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria ††Department of Oral Biology, St James's University Hospital, University of Leeds, Leeds, UK ‡‡Department of Experimental Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675 Munich, Germany.
Introduction:
Multiple organ dysfunction syndrome (MODS) and the resulting multiple organ failure (MOF) following severe trauma are associated with increased morbidity and mortality. Due to intestinal mucosal lesions and gut barrier disorders, the intestine contributes decisively to how post-traumatic MOF develops. As mild therapeutic hypothermia has been found to have protective effects on post-traumatic organ injuries, we analysed its effects on the intestine.
Methods:
In a porcine model, Forty pigs were assigned to four groups: sham or trauma groups each with two sub-groups receiving either hypothermia or normothermia. The trauma was a combined trauma of blunt chest trauma, liver laceration and haemorrhagic shock. Functional enterocyte mass and enterocyte necrosis were evaluated by measuring plasma citrulline and iFABP. Mucosal lesions were assessed using a semi-quantitative histological scoring system.
Results:
In normothermic trauma animals, citrulline decreased significantly compared to both sham groups and to the hypothermic trauma group. However, citrulline levels did not differ significantly between the hypothermic trauma group and the hypothermic sham group. Although histological analysis demonstrated subepithelial lifting and mucosal oedema in the ileal mucosa of all trauma animals, the semi-quantitative score of the group treated with hypothermia was comparable to that of the hypothermic sham group. However, the score was significantly elevated in normothermic trauma animals in comparison to sham and hypothermic trauma animals.
Conclusion:
Induced hypothermia preserves the functional enterocyte mass after severe trauma. Therefore induced hypothermia might represent a therapeutic strategy to avoid posttraumatic organ dysfunction, although further studies regarding the safety and long-term effects are required.
Level Of Evidence:
Level III; therapeutic study.
Insights
Mild therapeutic hypothermia preserves intestinal function after severe trauma. This protective effect may help prevent post-traumatic organ failure, but further research is needed on its safety and long-term outcomes.
Area of Science:
- Trauma and Surgical Critical Care
- Gastroenterology
- Organ Injury and Protection
Background:
- Severe trauma can lead to multiple organ dysfunction syndrome (MODS) and failure (MOF).
- The intestine plays a critical role in the development of post-traumatic MOF due to mucosal lesions and gut barrier dysfunction.
- Mild therapeutic hypothermia has shown potential in protecting against post-traumatic organ injuries.
Purpose of the Study:
- To investigate the effects of mild therapeutic hypothermia on intestinal integrity and function following severe combined trauma in a porcine model.
- To determine if hypothermia can mitigate trauma-induced enterocyte damage and mucosal lesions.
Main Methods:
- A porcine model was used, with 40 pigs divided into sham or trauma groups, each receiving either hypothermia or normothermia.
- Severe combined trauma involved blunt chest trauma, liver laceration, and hemorrhagic shock.
- Enterocyte mass and necrosis were assessed via plasma citrulline and iFABP; mucosal lesions were evaluated using histological scoring.
Main Results:
- Normothermic trauma significantly decreased plasma citrulline levels compared to sham and hypothermic trauma groups.
- Histological analysis revealed significant ileal mucosal edema and subepithelial lifting in normothermic trauma animals.
- Hypothermia treatment resulted in histological scores comparable to sham groups, preserving functional enterocyte mass.
Conclusions:
- Induced hypothermia effectively preserves functional enterocyte mass after severe trauma.
- Hypothermia may serve as a therapeutic strategy to prevent post-traumatic organ dysfunction.
- Further studies are necessary to evaluate the safety and long-term effects of hypothermia in trauma patients.
