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Sevoflurane provides better haemodynamic stability than propofol during right ventricular ischaemia-reperfusion

Haraldsen, Pernille LU ; Cunha-Goncalves, Doris LU ; Metzsch, Carsten LU orcid ; Algotsson, Lars LU ; Lindstedt, Sandra LU and Ingemansson, Richard LU (2020) In Interactive Cardiovascular and Thoracic Surgery 30(1). p.129-135
Abstract

OBJECTIVES: To assess whether sevoflurane provides better haemodynamic stability than propofol in acute right ventricular (RV) ischaemia-reperfusion. METHODS: Open-chest pigs (mean ± standard deviation, 68.8 ± 4.2 kg) anaesthetized with sevoflurane (n = 6) or propofol (n = 6) underwent 60 min of RV free wall ischaemia and 150 min of reperfusion. Haemodynamic parameters and blood flow in the 3 major coronary arteries were continuously monitored. Biomarkers of cardiac ischaemia were analysed. RESULTS: Mean arterial pressure and stroke volume decreased, whereas pulmonary vascular resistance increased equally in both groups. Heart rate increased 7.5% with propofol (P < 0.05) and 17% with sevoflurane (P < 0.05). At reperfusion, left... (More)

OBJECTIVES: To assess whether sevoflurane provides better haemodynamic stability than propofol in acute right ventricular (RV) ischaemia-reperfusion. METHODS: Open-chest pigs (mean ± standard deviation, 68.8 ± 4.2 kg) anaesthetized with sevoflurane (n = 6) or propofol (n = 6) underwent 60 min of RV free wall ischaemia and 150 min of reperfusion. Haemodynamic parameters and blood flow in the 3 major coronary arteries were continuously monitored. Biomarkers of cardiac ischaemia were analysed. RESULTS: Mean arterial pressure and stroke volume decreased, whereas pulmonary vascular resistance increased equally in both groups. Heart rate increased 7.5% with propofol (P < 0.05) and 17% with sevoflurane (P < 0.05). At reperfusion, left atrial pressure and systemic vascular resistance decreased with sevoflurane. While RV stroke work (mmHg·ml) and cardiac output (l·min-1) decreased in the propofol group (4.2 ± 1.2 to 2.9 ± 1.7 and 2.65 ± 0.44 to 2.28 ± 0.56, respectively, P < 0.05 both), they recovered to baseline levels in the sevoflurane group (4.1 ± 1.5 to 4.0 ± 1.5 and 2.77 ± 0.6 to 2.6 ± 0.5, respectively, P > 0.05). Circumflex and left anterior descending coronary artery blood flow decreased in both groups. Right coronary artery blood flow (ml·min-1) decreased with propofol (38 ± 9 to 28 ± 9, P < 0.05), but not with sevoflurane (28 ± 11 to 28 ± 17, P > 0.05). Biomarkers of cardiac ischaemia increased in both groups. CONCLUSIONS: Compared to propofol, sevoflurane-anaesthetized pigs showed higher RV stroke work, cardiac output and right coronary artery blood flow during reperfusion. These findings warrant a clinical trial of sevoflurane in RV ischaemia in humans.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardioprotection, Ischaemia–reperfusion, Propofol, Right ventricular, Sevoflurane
in
Interactive Cardiovascular and Thoracic Surgery
volume
30
issue
1
pages
7 pages
publisher
European Association of Cardio-Thoracic Surgery
external identifiers
  • pmid:31580431
  • scopus:85077226039
ISSN
1569-9285
DOI
10.1093/icvts/ivz235
language
English
LU publication?
yes
id
c8761b6c-ebd9-411c-a1d4-a348572837d7
date added to LUP
2020-01-10 11:10:04
date last changed
2024-10-02 19:35:23
@article{c8761b6c-ebd9-411c-a1d4-a348572837d7,
  abstract     = {{<p>OBJECTIVES: To assess whether sevoflurane provides better haemodynamic stability than propofol in acute right ventricular (RV) ischaemia-reperfusion. METHODS: Open-chest pigs (mean ± standard deviation, 68.8 ± 4.2 kg) anaesthetized with sevoflurane (n = 6) or propofol (n = 6) underwent 60 min of RV free wall ischaemia and 150 min of reperfusion. Haemodynamic parameters and blood flow in the 3 major coronary arteries were continuously monitored. Biomarkers of cardiac ischaemia were analysed. RESULTS: Mean arterial pressure and stroke volume decreased, whereas pulmonary vascular resistance increased equally in both groups. Heart rate increased 7.5% with propofol (P &lt; 0.05) and 17% with sevoflurane (P &lt; 0.05). At reperfusion, left atrial pressure and systemic vascular resistance decreased with sevoflurane. While RV stroke work (mmHg·ml) and cardiac output (l·min-1) decreased in the propofol group (4.2 ± 1.2 to 2.9 ± 1.7 and 2.65 ± 0.44 to 2.28 ± 0.56, respectively, P &lt; 0.05 both), they recovered to baseline levels in the sevoflurane group (4.1 ± 1.5 to 4.0 ± 1.5 and 2.77 ± 0.6 to 2.6 ± 0.5, respectively, P &gt; 0.05). Circumflex and left anterior descending coronary artery blood flow decreased in both groups. Right coronary artery blood flow (ml·min-1) decreased with propofol (38 ± 9 to 28 ± 9, P &lt; 0.05), but not with sevoflurane (28 ± 11 to 28 ± 17, P &gt; 0.05). Biomarkers of cardiac ischaemia increased in both groups. CONCLUSIONS: Compared to propofol, sevoflurane-anaesthetized pigs showed higher RV stroke work, cardiac output and right coronary artery blood flow during reperfusion. These findings warrant a clinical trial of sevoflurane in RV ischaemia in humans.</p>}},
  author       = {{Haraldsen, Pernille and Cunha-Goncalves, Doris and Metzsch, Carsten and Algotsson, Lars and Lindstedt, Sandra and Ingemansson, Richard}},
  issn         = {{1569-9285}},
  keywords     = {{Cardioprotection; Ischaemia–reperfusion; Propofol; Right ventricular; Sevoflurane}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{129--135}},
  publisher    = {{European Association of Cardio-Thoracic Surgery}},
  series       = {{Interactive Cardiovascular and Thoracic Surgery}},
  title        = {{Sevoflurane provides better haemodynamic stability than propofol during right ventricular ischaemia-reperfusion}},
  url          = {{http://dx.doi.org/10.1093/icvts/ivz235}},
  doi          = {{10.1093/icvts/ivz235}},
  volume       = {{30}},
  year         = {{2020}},
}