• Matthias Fröhlich, Marc Maegele, Frank Hildebrand, Matthias Weuster, Philipp Mommsen, Juliane Mohr, Ingo Witte, Roman Pfeifer, Georg Feichtinger, Claudia Keibl, Sascha Flohé, and Martijn van Griensven.
• *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.
• Shock. 2016 May 24.

IntroductionMultiple 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.MethodsIn 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.ResultsIn 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.ConclusionInduced 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 EvidenceLevel III; therapeutic study.

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