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

Abstract

Background: Despite considerable advances in our knowledgeof the pathophysiology of inhalation injury, there arefew specific therapeutic options, and patient care is mainlysupportive. Platelets release growth factors and other immunesystem components to start healing process. By using nebulizedPlatelet Rich Plasma (PRP), platelets may reduce inflammationand stimulates bronchial tree healing. However, there are noclear data supporting or refuting the use of inhaled PRP ininhalation injury.Objective: To evaluate the role of nebulized autologousPlatelet Rich Plasma (PRP) in management of Smoke InhalationInjury (SII) as early adjuvant therapeutic and prognosticmodality.Methods: This is prospective study that included 40patients with burns 25-50% TBSA and have inhalation lunginjury. They were divided into 2 groups; 20 patients receivedaerosolized particles of nebulized PRP beside regular regimen.The other control group included 20 patients and receivedregular treatment regimen only.Results: There was a statistical significant difference(p<0.01) of biologic changes in upper airway with smokeinjury in study group patients compared to control grouppatients who received regular protocol measured at the samefollow-up time interval, relatively same TBSA and initialbronchoscopy scoring. The mean extubation time was 7±1days in study group compared to 14±1 days in control group.Study group less showed shorter hospital stay and less mortalityrate.Conclusion: The application of aerosolize the PRP solutionin the nebulizer with regular treatment protocol of inhalationburn patients could be a beneficial therapeutic tool for regeneratingof post burn damaged tracheo-broncho-pulmonarytree. Further studies on larger patient population with clinicaland pathological evidences are warranted