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Tracheobronchial and pulmonary cytologic changes in shock.

Z Freidman-Mor, J Chalon, J S Katz

The Journal of Trauma

|January 1, 1976

Summary

Patients in hemorrhagic shock show increased iron-laden histiocytes in lung secretions. This suggests iron deposition in lungs during low-flow states, identified using Prussian blue staining.

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Area of Science:

Pulmonary Pathology
Cellular Biology
Hematology

Background:

Histiocytes are immune cells that can accumulate substances.
Morphologically abnormal histiocytes were observed in tracheobronchial washings from patients in hemorrhagic shock.
The composition of the accumulated substance within these histiocytes was unknown.

Purpose of the Study:

To investigate the composition of the substance within abnormal histiocytes found in patients experiencing hemorrhagic shock.
To determine if inorganic iron is a component of the material accumulating in histiocytes during shock.
To compare the prevalence of iron-laden histiocytes in shock patients versus a control group.

Main Methods:

Cytochemical staining (Prussian blue method) was used to detect inorganic iron in histiocytes from tracheobronchial washings.

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Histologic studies were performed on rats subjected to hemorrhagic shock.

Comparison of iron-laden histiocyte counts in shocked patients and animals versus control groups.

Main Results:

Histiocytes in tracheobronchial secretions from patients in hemorrhagic shock contained significant amounts of inorganic iron (up to 40%), detectable by Prussian blue staining.
Control subjects showed minimal iron-laden histiocytes (2%).
Histologic studies in rats confirmed increased iron-laden histiocytes in the lungs of shocked animals compared to controls.

Conclusions:

Hemorrhagic shock is associated with the accumulation of iron within histiocytes in the lungs.
Inorganic iron deposition in the lungs may occur during low-flow states like hemorrhagic shock.
These findings highlight a potential mechanism of iron sequestration in the pulmonary system during critical illness.