PMID- 25626738
OWN - NLM
STAT- MEDLINE
DCOM- 20160229
LR  - 20181202
IS  - 1399-6576 (Electronic)
IS  - 0001-5172 (Linking)
VI  - 59
IP  - 6
DP  - 2015 Jul
TI  - Biomarkers of inflammation in major vascular surgery: a prospective randomised 
      trial.
PG  - 773-87
LID - 10.1111/aas.12466 [doi]
AB  - BACKGROUND: Surgery induces inflammation and pro-inflammatory cytokines are 
      associated with post-operative complications. In cardiac surgery, it has been 
      shown that volatile anaesthetics have cardioprotective properties. We explored 
      whether sevoflurane affects the pro-inflammatory response favourably compared 
      with total intravenous anaesthesia (TIVA) after surgery. METHODS: We measured 
      monocyte chemotactic protein 1 (MCP-1), matrix metalloproteinase 9 (MMP-9), 
      C-reactive protein (CRP), vascular cell adhesion molecule 1 (VCAM-1), interleukin 
      (IL)-6 and IL-8 perioperatively and evaluated if the anaesthetic regimen affected 
      these mediators. Our hypothesis was that sevoflurane-based anaesthesia is 
      associated with a reduced release of biomarkers of inflammation compared with 
      TIVA with propofol/remifentanil. RESULTS: In the total population, MCP-1, MMP-9, 
      IL-6 and IL-8 increased 30 min after arrival intensive care unit, compared with 
      before surgery (P < 0.001), whereas CRP and VCAM-1 transiently declined 
      (P < 0.001). From 30 min after arrival intensive care unit to 1st post-operative 
      day, MCP-1 and IL-6 levels declined (P < 0.001), CRP and VCAM-1 increased 
      (P < 0.001), whereas MMP-9 and IL-8 were not significantly altered. 
      Pre-operatively there were no significant differences in any variables between 
      the two anaesthetic groups. Lower levels of MCP-1 and IL-8 (P < 0.001) and higher 
      levels of IL-6 and MMP-9 (P = 0.003) were found in the sevoflurane group, 
      compared with the TIVA group 30 min post-operatively. CRP and VCAM-1 levels did 
      not differ. There were no significant differences between the two anaesthetic 
      groups before surgery or at 1st post-operative day. CONCLUSION: We found an 
      inflammatory response during the observation period, which was modified by the 
      anaesthetic regimen in the early phase. This short-lasting difference is probably 
      too short to support a cardioprotective effect of sevoflurane compared with TIVA 
      in open abdominal aortic surgery.
CI  - (c) 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John 
      Wiley & Sons Ltd.
FAU - Lindholm, E E
AU  - Lindholm EE
AD  - Department of Anaesthesiology, Vestfold Hospital Trust, Tonsberg, Norway.
FAU - Aune, E
AU  - Aune E
AD  - Department of Cardiology, Vestfold Hospital Trust, Tonsberg, Norway.
FAU - Seljeflot, I
AU  - Seljeflot I
AD  - Center for Clinical Heart Research, Department of Cardiology, Oslo University 
      Hospital, Oslo, Norway.
AD  - Faculty of Medicine, University of Oslo, Oslo, Norway.
FAU - Otterstad, J E
AU  - Otterstad JE
AD  - Department of Cardiology, Vestfold Hospital Trust, Tonsberg, Norway.
FAU - Kirkeboen, K A
AU  - Kirkeboen KA
AD  - Department of Anaesthesiology, Oslo University Hospital, Oslo, Norway.
AD  - Faculty of Medicine, University of Oslo, Oslo, Norway.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20150128
PL  - England
TA  - Acta Anaesthesiol Scand
JT  - Acta anaesthesiologica Scandinavica
JID - 0370270
RN  - 0 (Anesthetics, Inhalation)
RN  - 0 (Anesthetics, Intravenous)
RN  - 0 (Biomarkers)
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Chemokine CCL2)
RN  - 0 (Cytokines)
RN  - 0 (Interleukin-6)
RN  - 0 (Interleukin-8)
RN  - 0 (Methyl Ethers)
RN  - 0 (Vascular Cell Adhesion Molecule-1)
RN  - 38LVP0K73A (Sevoflurane)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - EC 3.4.24.35 (Matrix Metalloproteinase 9)
SB  - IM
MH  - Aged
MH  - Anesthesia, Intravenous
MH  - Anesthetics, Inhalation/blood/pharmacology
MH  - Anesthetics, Intravenous/blood/pharmacology
MH  - Biomarkers/blood
MH  - C-Reactive Protein
MH  - Cardiotonic Agents/blood
MH  - Chemokine CCL2/blood
MH  - Cytokines/*blood/drug effects
MH  - Female
MH  - Humans
MH  - Inflammation/*blood
MH  - Interleukin-6/blood
MH  - Interleukin-8/blood
MH  - Male
MH  - Matrix Metalloproteinase 9/blood
MH  - Methyl Ethers/*blood/*pharmacology
MH  - Postoperative Complications/*blood
MH  - Prospective Studies
MH  - Sevoflurane
MH  - Vascular Cell Adhesion Molecule-1/blood
MH  - *Vascular Surgical Procedures
EDAT- 2015/01/30 06:00
MHDA- 2016/03/02 06:00
CRDT- 2015/01/29 06:00
PHST- 2014/12/01 00:00 [received]
PHST- 2014/12/10 00:00 [accepted]
PHST- 2015/01/29 06:00 [entrez]
PHST- 2015/01/30 06:00 [pubmed]
PHST- 2016/03/02 06:00 [medline]
AID - 10.1111/aas.12466 [doi]
PST - ppublish
SO  - Acta Anaesthesiol Scand. 2015 Jul;59(6):773-87. doi: 10.1111/aas.12466. Epub 2015 
      Jan 28.