401 Markers of Smoke Inhalation Injury in Adult Burned Patients

Inhalation injury continues to represent a major source of morbidity and mortality in burned patients. The aim of the present study is to examine potential markers of smoke inhalation injury in adult burned patients classified with either mild, moderate, severe, or no inhalation injury within one year after injury. Inhalation injury was classified into one of four groups in adult burned patients (n=21, 20 ± 19% total body surface area burn, ages 47 ± 15 years), and plasma was collected from each subject. An amino acid panel, along with concentrations of asymmetric (ADMA) and symmetric dimethylarginine (SDMA), was analyzed for each sample. Significance was accepted at p<0.05. Systemic concentrations of proline, which is a precursor to collagen, were significantly increased in subjects with moderate inhalation injury compared to subjects without inhalation injury (p<0.05). Both leucine and norleucine were significantly higher in subjects with moderate and severe inhalation injury compared to subjects without inhalation injury (p<0.01). Subjects with severe inhalation injury had significantly lower SDMA compared to subjects without inhalation injury (p<0.05), and there were no significant differences in ADMA between all groups. Subjects with greater severity of inhalation injury have increased systemic proline concentrations. Therapeutic targets that would enable interruption of this sequence leading to lung injury in burned patients are necessary.