Experimental Investigation Of Effect Of Seawater Immersion On Endothelial Cells' Hemostasis Function In Dogs Sustained By Combined War-Injuries

Objective: In the modern naval warfare, the rate of the wounded is much higher than other style of battles. The main wounds include combined war-injuries,such as burn-blast and burn-firearm combined injury, which may be immersed in the hyperosmotic basic and cold seawater containing marine bacteria as naval ships were hit by missiles ,bombs or water mine and sunk. When seawater immersion, the primary vascular endothelial cell injury induced by combined war-injuries was deteriorated and resulted in the acute syndromes of vasospasm and the disorder of hemostasia. Studying on endothelial cell injury associated with seawater immersion would help to improve the early therapeutic effect.Methods: The dog models of burn-blast combined injury and burn-firearm combined injury were developed. The dogs with burn-blast combined injury or burn-firearm combined injury were randomly divided into two groups: respectively immersion group and control group. In immersion group, the dogs were immersed in seawater for 4 hours, then were taken out from seawater and dried with warm wind. Blood samples were withdrawn from central vein before wound, immediately after immersion, 3h after immersion, 6h after immersion, 16h after immersion and 24h after immersion to measured circulatingendothelial cells (CEC), von Willebrand Factor (vWF), Tissue-type plasminogen activator (t-PA), Plasminogen activator inhibtor (PAI) and Thromboxane B2/6-keto-Prostaglandin F,Q (TXB2/6-K-PGF, 0) and to check the morphologic changes in lung tissue after the experiment was finished. Control group was the same as immersion group except unimmersion.Results: 1. The effect of seawater immersion after burn-blast combined injury on endothelial cell' hemostasis: The level of CEC, vWF, PAI-1 and TXB2/6-K-PGF, a Elevated, while the level of t-PA reduced at 4h after wound in control group; The level of CEC, vWF, PAI-1 and TXB2/6-K-PGF, a significantly elevated while the level of t-PA significantly reduced at every time in immersion group and immersion group was significantly different with control group. The morphologic changes of lung tissue showed some thrombosis. 2. The effect of seawater immersion after burn-firearm combined injury on endothelial cell' hemostasis: The level of CEC, vWF, PAI-1 and TXB2/6-K-PGF, ?elevated, while t-PA reduced at 4h and 7h after wound in control group; The level of CEC, vWF, PAI-1 and TXB2/6-K-PGF, ?significantly elevated continually while the level of t-PA significantly reduced during the whole period in immersion group, and immersion group was significantly different with control group. The morphologic changes of lung tissue showed some thrombosis.Conclusions: The results suggested that seawater immersion after combined war-injuries(included burn-blast combined injury and burn-firearm combined injury) would cause extensive acute damage of endothelial cells anda disorder of hemostasia, so it trends to result in thrombosis. The damage ofinimmersion and combined combat-injuries is more severe and longer than that of simple combinedcombat-injuries. The peak of seawater immersion after burn-blast combined injury on endothelial cell was at immediately after immersion or 3h after immersion; while the peak of seawater immersion after burn-firearm combined injury on endothelial cell delayed and it was at 16h or24h after immersion. The changes of vWF, t-PA, PAI-1, TXB2 and 6-K-PGF,a concentration could be a marker of thrombosis.