Alpha-trinositol reduces edema formation at the site of scald injury

Background: The effects of α-trinositol (1 D -myo-inositol-1,2,6-triphosphate, IP 3) on burn-induced edema formation were investigated. Methods: Lymph flow (Q L; μl/min) and lymph-to-plasma protein ratio (C L/C P) were monitored in groups of five to six dogs before and 4 hours after (1) a 5-second 100° C or 90° C foot paw scald; (2) IP 3 (45 mg/kg intravenous bolus, then a 20 mg/kg/hr infusion) 30 minutes before or after 100° C scald, or 30 minutes after 90° C scald. Hind paw venous pressure was elevated and maintained by outflow restriction until reaching steady state Q L and (C L/C P) min. Macromolecular reflection coefficient (1 – C L/C P) was measured. Fluid filtration coefficient (K f; ml/min/mm Hg/100 gm) was calculated. Relative paw weight gain (%) was measured. Results: Compared with preburn values, scald uniformly produced significant increases in Q L, C L/C P, and K f. IP 3 significantly ( p < 0.02, ANOVA) reduced paw weight gain when given before, but not after, 100° C burn (41% ± 5% versus 18% ± 7% preburn IP 3 and 31% ± 3% postburn IP 3). Compared with 90° C burn animals, postburn treatment significantly ( p < 0.017) attenuated 4-hour increases in Q L (550 ± 87 versus 252 ± 29 μl/min), K f (0.016 ± 00 versus 0.007 ± 00 μl/min/mm/Hg/100gm), and relative paw weight gain (28% ± 3% versus 12% ± 5%). Conclusions: α-Trinositol given after a 90° C scald blunted edema formation at the site of scald, likely through reduced transmembrane fluid flux. (Surgery 1998;123:36-45.)