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Anesthesia Aggravates Lung Damage and Precipitates Hypotension in Endotoxemic Sheep

Soehnlein, Oliver; Eriksson, Stefan; Hjelmqvist, Hans; Andersson, Andreas; Mörgelin, Matthias LU ; Lindbom, Lennart; Rundgren, Mats and Frithiof, Robert (2010) In Shock 34(4). p.412-419
Abstract
Beneficial anti-inflammatory properties have been ascribed to volatile anesthetics in septic conditions, but no studies have compared anesthesia to the conscious state in a large-animal model. The aim of this study was to investigate the effect of isoflurane anesthesia on cardiovascular and respiratory function, leukocyte activation, and lung damage in a model of endotoxemia in sheep. Conscious (n = 6) and anesthetized (n = 6) sheep were made endotoxemic by continuous infusion of LPS for 48 h. Central hemodynamics were monitored continuously, and blood samples were collected regularly. Activation of leukocytes was assessed by surface expression of CD11b and plasma myeloperoxidase concentration. Lung damage was determined by electron... (More)
Beneficial anti-inflammatory properties have been ascribed to volatile anesthetics in septic conditions, but no studies have compared anesthesia to the conscious state in a large-animal model. The aim of this study was to investigate the effect of isoflurane anesthesia on cardiovascular and respiratory function, leukocyte activation, and lung damage in a model of endotoxemia in sheep. Conscious (n = 6) and anesthetized (n = 6) sheep were made endotoxemic by continuous infusion of LPS for 48 h. Central hemodynamics were monitored continuously, and blood samples were collected regularly. Activation of leukocytes was assessed by surface expression of CD11b and plasma myeloperoxidase concentration. Lung damage was determined by electron microscopy, cell count in bronchoalveolar lavage fluid, and analysis of lung vascular permeability. Four additional animals (two conscious and two anesthetized) went through the same protocol but did not receive LPS. LPS infusion induced a hyperdynamic sepsis. The drop in total peripheral resistance was compensated by an increase in heart rate and cardiac output in the conscious group, whereas anesthetized sheep failed to compensate in this way. Endotoxemic isoflurane-anesthetized sheep also showed signs of aggravated lung edema formation and tissue damage together with enhanced neutrophil activation and lung tissue accumulation. Our data suggest that isoflurane in conjunction with mechanical ventilation blunts cardiovascular compensatory mechanisms in sepsis and enhances leukocyte activation, which may contribute to lung edema formation and tissue damage. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
mechanisms, autonomic regulatory, neutrophil, lung injury, Sepsis, isoflurane
in
Shock
volume
34
issue
4
pages
412 - 419
publisher
BioMedical Press
external identifiers
  • wos:000281907800015
  • scopus:77957720473
ISSN
1540-0514
DOI
10.1097/SHK.0b013e3181d8e4f5
language
English
LU publication?
yes
id
e9dcc581-2eef-4e7b-95df-36f30855cf8c (old id 1696208)
date added to LUP
2010-10-25 12:03:37
date last changed
2018-05-29 10:41:51
@article{e9dcc581-2eef-4e7b-95df-36f30855cf8c,
  abstract     = {Beneficial anti-inflammatory properties have been ascribed to volatile anesthetics in septic conditions, but no studies have compared anesthesia to the conscious state in a large-animal model. The aim of this study was to investigate the effect of isoflurane anesthesia on cardiovascular and respiratory function, leukocyte activation, and lung damage in a model of endotoxemia in sheep. Conscious (n = 6) and anesthetized (n = 6) sheep were made endotoxemic by continuous infusion of LPS for 48 h. Central hemodynamics were monitored continuously, and blood samples were collected regularly. Activation of leukocytes was assessed by surface expression of CD11b and plasma myeloperoxidase concentration. Lung damage was determined by electron microscopy, cell count in bronchoalveolar lavage fluid, and analysis of lung vascular permeability. Four additional animals (two conscious and two anesthetized) went through the same protocol but did not receive LPS. LPS infusion induced a hyperdynamic sepsis. The drop in total peripheral resistance was compensated by an increase in heart rate and cardiac output in the conscious group, whereas anesthetized sheep failed to compensate in this way. Endotoxemic isoflurane-anesthetized sheep also showed signs of aggravated lung edema formation and tissue damage together with enhanced neutrophil activation and lung tissue accumulation. Our data suggest that isoflurane in conjunction with mechanical ventilation blunts cardiovascular compensatory mechanisms in sepsis and enhances leukocyte activation, which may contribute to lung edema formation and tissue damage.},
  author       = {Soehnlein, Oliver and Eriksson, Stefan and Hjelmqvist, Hans and Andersson, Andreas and Mörgelin, Matthias and Lindbom, Lennart and Rundgren, Mats and Frithiof, Robert},
  issn         = {1540-0514},
  keyword      = {mechanisms,autonomic regulatory,neutrophil,lung injury,Sepsis,isoflurane},
  language     = {eng},
  number       = {4},
  pages        = {412--419},
  publisher    = {BioMedical Press},
  series       = {Shock},
  title        = {Anesthesia Aggravates Lung Damage and Precipitates Hypotension in Endotoxemic Sheep},
  url          = {http://dx.doi.org/10.1097/SHK.0b013e3181d8e4f5},
  volume       = {34},
  year         = {2010},
}