The Efficacy of Autologous Nebulized Platelet Rich Plasma (PRP) As an Early Adjuvant Therapeutic and Prognostic Treatment Modality in the Management of Inhalation Lung Injury | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 8, Volume 43, Issue 2, July 2019, Page 203-208 PDF (6.64 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2019.65115 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Shereine M Salama* ; Ibrahim H Kamel; Mohamed Ghanim; Ahmad F Elsherif | ||||
| The Department of Plastic, Burns and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Despite considerable advances in our knowledge of the pathophysiology of inhalation injury, there are few specific therapeutic options, and patient care is mainly supportive. Platelets release growth factors and other immune system components to start healing process. By using nebulized Platelet Rich Plasma (PRP), platelets may reduce inflammation and stimulates bronchial tree healing. However, there are no clear data supporting or refuting the use of inhaled PRP in inhalation injury. Objective: To evaluate the role of nebulized autologous Platelet Rich Plasma (PRP) in management of Smoke Inhalation Injury (SII) as early adjuvant therapeutic and prognostic modality. Methods: This is prospective study that included 40 patients with burns 25-50% TBSA and have inhalation lung injury. They were divided into 2 groups; 20 patients received aerosolized particles of nebulized PRP beside regular regimen. The other control group included 20 patients and received regular treatment regimen only. Results: There was a statistical significant difference (p<0.01) of biologic changes in upper airway with smoke injury in study group patients compared to control group patients who received regular protocol measured at the same follow-up time interval, relatively same TBSA and initial bronchoscopy scoring. The mean extubation time was 7±1 days in study group compared to 14±1 days in control group. Study group less showed shorter hospital stay and less mortality rate. Conclusion: The application of aerosolize the PRP solution in the nebulizer with regular treatment protocol of inhalation burn patients could be a beneficial therapeutic tool for regenerating of post burn damaged tracheo-broncho-pulmonary tree. Further studies on larger patient population with clinical and pathological evidences are warranted | ||||
| Keywords | ||||
| Smoke inhalation injury – Respiratory management; – PRP inhalation | ||||
| References | ||||
|
W.R. Clark: Smoke inhalation; diagnosis and treatment, World J. Surg., 16: 24, 1992. 2- E.C. Kimmel and K.R. Still: Acute lung injury, acute respiratory distress syndrome and inhalation injury: An overview, Drug Chem. Toxicol., 22: 91, 1999. 3- L.C. Cancio: Airway management and smoke inhalation injury in the burn patient, Clin. Plast. Surg., 36: 555, 2009. 4- H. Yamamura, S. Kaga, K. Kaneda and Y. Mizobata: Chest computed tomography performed on admission helps predict the severity of smoke-inhalation injury, Crit. Care, 17: R95, 2013. 5- R.P. Mlcak, O.E. Suman and D.N. Herndon: Respiratory management of inhalation injury, Burns, 33 (1): 2-13, 2007. 6- M.J. Mosier, T.N. Pham, D.R. Park, J. Simmons, M.B. Klein and N.S. Gibran: Predictive value of bronchoscopy in assessing the severity of inhalation injury, J. Burn Care Res., 33 (1): 65-73, 2012. 7- J.M. Albright, C.S. Davis, M.D. Bird, L. Ramirez, H. Kim, E.L. Burnham, et al.: The acute pulmonary inflammatory response to the graded severity of smoke inhalation injury, Crit. Care Med., 40 (4): 1113-21, 2012. 8- R.P. Mlcak, O.E. Suman and D.N. Herndon: Respiratory management of inhalation injury, Burns, 33 (1): 2-13, 2007. 9- Albright J.M., Davis C.S., Bird M.D., Ramirez L., Kim H., Burnham E.L., et al.: The acute pulmonary inflammatory response to the graded severity of smoke inhalation injury. Crit. Care Med., 40: 1113-21, 2012. 10- Challenges in Research on the Pathophysiology of Smoke Inhalation Injury and Its Clinical Management Lancet. October 01; 388 (10052): 1437-1446. doi:10.1016/S0140- 6736 (16)31458-1, 2016. 11- Platelet-rich plasma: A review of biology and applications in plastic surgery. Eppley B.L., et al.: Plast. Reconstr. Surg., 2006. 12- Klement G.L., Yip T.T., Cassiola F., Kikuchi L., Cervi D., Podust V., Italiano J.E., Wheatley E., Abou-Slaybi A., Bender E., et al.: Platelets actively sequester angiogenesis regulators. Blood, 113: 2835-2842, 2009. 13- Demidova-Rice T.N., Wolf L., Deckenback J., Hamblin M.R. and Herman I.M.: Human platelet-rich plasma-and extracellular matrix-derived peptides promote impaired cutaneous wound healing in vivo. PLoS One, 7: e32146, 2012. 14- Mammoto T., Jiang A., Jiang E. and Mammoto A.: Platelet rich plasma extract promotes angiogenesis through the angiopoietin1-Tie2 pathway. Microvasc. Res., 89: 15-24, 2013. 15- Nebulizer Applies PRP Directly to Damaged Lungs NEWS PROVIDED BY Dr. Prabhat. Soni. Jul. 13, 08: 40 ET, 2015. 16- Challenges in Research on the Pathophysiology of Smoke Inhalation Injury and Its Clinical Management Lancet. 208 Vol. 43, No. 2 / The Efficacy of Autologous Nebulized PRP as an Early Adjuvant Therapeutic October 01; 388 (10052): 1437-1446. Doi: 10.1016/S0140- 6736(16)31458-1, 2016. 17- Prockop L. and Chichkova R.: Carbon monoxide intoxication: An updated review. J. Neurol. Sci., 262: 122-30. [PubMed], 2007. 18- Yurt R.W., Bessey P.Q., Bauer G.J., et al.: A regional burn center's response to a disaster: September 11, 2001, and the days beyond. J. Burn Care Rehabil., 26 (2): 117-124. [PubMed: 15756112], 2005. 19- Ihara K., Fujuda S., Enkhtaivan B., et al.: Abstract 19670: Adipose-derived Mesenchymal Stem Cells Attenuate Pulmonary MicrovascularHyperpermeability After Smoke Inhalation. Circulation, 132 (Suppl 3): A19670, 2015. 20- Acceleration of Lung Regeneration by Platelet-Rich Plasma Extract through the Low-Density Lipoprotein Receptor-Related Protein 5-Tie2 Pathway Am. J. Respir. Cell. Mol. Biol., Jan., 54 (1): 103-113, 2016 | ||||
|
Statistics Article View: 764 PDF Download: 1,671 |
||||
