PMID- 27782948
OWN - NLM
STAT- MEDLINE
DCOM- 20170710
LR  - 20181202
IS  - 1526-7598 (Electronic)
IS  - 0003-2999 (Linking)
VI  - 124
IP  - 1
DP  - 2017 Jan
TI  - Sevoflurane Abolishes Oxygenation Impairment in a Long-Term Rat Model of Acute 
      Lung Injury.
PG  - 194-203
AB  - BACKGROUND: Patients experiencing acute lung injury (ALI) often need mechanical 
      ventilation for which sedation may be required. In such patients, usually the 
      first choice an intravenously administered drug. However, growing evidence 
      suggests that volatile anesthetics such as sevoflurane are a valuable 
      alternative. In this study, we evaluate pulmonary and systemic effects of 
      long-term (24-hour) sedation with sevoflurane compared with propofol in an in 
      vivo animal model of ALI. METHODS: Adult male Wistar rats were subjected to ALI 
      by intratracheal lipopolysaccharide (LPS) application, mechanically ventilated 
      and sedated for varying intervals up to 24 hours with either sevoflurane or 
      propofol. Vital parameters were monitored, and arterial blood gases were 
      analyzed. Inflammation was assessed by the analysis of bronchoalveolar lavage 
      fluid (BALF), cytokines (monocyte chemoattractant protein-1 [MCP-1], 
      cytokine-induced neutrophil chemoattractant protein-1 [CINC-1], interleukin 
      [IL-6], IL-12/12a, transforming growth factor-beta, and IL-10) in blood and lung 
      tissue and inflammatory cells. The alveolocapillary barrier was indirectly 
      assessed by wet-to-dry ratio, albumin, and total protein content in BALF. Results 
      are presented as mean +/- standard deviation. RESULTS: After 9 hours of ventilation 
      and sedation, oxygenation index was higher in the LPS/sevoflurane (LPS-S) than in 
      the LPS/propofol group (LPS-P) and reached 400 +/- 67 versus 262 +/- 57 mm Hg after 
      24 hours (P < .001). Cell count in BALF in sevoflurane-treated animals was lower 
      after 18 hours (P = .001) and 24 hours (P < .001) than in propofol controls. Peak 
      values of CINC-1 and IL-6 in BALF were lower in LPS-S versus LPS-P animals 
      (CINC-1: 2.7 +/- 0.7 vs 4.0 +/- 0.9 ng/mL; IL-6: 9.2 +/- 2.3 vs 18.9 +/- 7.1 pg/mL, both 
      P < .001), whereas IL-10 and MCP-1 did not differ. Also messenger RNAs of CINC-1, 
      IL-6, IL-12a, and IL-10 were significantly higher in LPS-P compared with LPS-S. 
      MCP-1 and transforming growth factor-beta showed no differences. Wet-to-dry ratio 
      was lower in LPS-S (5.4 +/- 0.2 vs 5.7 +/- 0.2, P = .016). Total protein in BALF did 
      not differ between P-LPS and S-LPS groups. CONCLUSIONS: Long-term sedation with 
      sevoflurane compared with propofol improves oxygenation and attenuates the 
      inflammatory response in LPS-induced ALI. Our findings suggest that sevoflurane 
      may improve lung function when used for sedation in patients with ALI.
FAU - Kellner, Patrick
AU  - Kellner P
AD  - From the *Institute of Anesthesiology, University Hospital Zurich, Zurich, 
      Switzerland; and daggerInstitute of Physiology, Zurich Center for Integrative Human 
      Physiology, University of Zurich, Zurich, Switzerland.
FAU - Muller, Mattia
AU  - Muller M
FAU - Piegeler, Tobias
AU  - Piegeler T
FAU - Eugster, Philipp
AU  - Eugster P
FAU - Booy, Christa
AU  - Booy C
FAU - Schlapfer, Martin
AU  - Schlapfer M
FAU - Beck-Schimmer, Beatrice
AU  - Beck-Schimmer B
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Anesth Analg
JT  - Anesthesia and analgesia
JID - 1310650
RN  - 0 (Anesthetics, Inhalation)
RN  - 0 (Anesthetics, Intravenous)
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Biomarkers)
RN  - 0 (Cytokines)
RN  - 0 (Inflammation Mediators)
RN  - 0 (Lipopolysaccharides)
RN  - 0 (Methyl Ethers)
RN  - 0 (lipopolysaccharide, E coli O55-B5)
RN  - 38LVP0K73A (Sevoflurane)
RN  - S88TT14065 (Oxygen)
RN  - YI7VU623SF (Propofol)
SB  - IM
CIN - Anesth Analg. 2017 Jan;124(1):7-8. PMID: 27984307
MH  - Acute Lung Injury/blood/chemically induced/physiopathology/*therapy
MH  - Anesthetics, Inhalation/*administration & dosage
MH  - Anesthetics, Intravenous/*administration & dosage
MH  - Animals
MH  - Anti-Inflammatory Agents/*administration & dosage
MH  - Biomarkers/blood
MH  - Blood-Air Barrier/drug effects/metabolism
MH  - Bronchoalveolar Lavage Fluid/chemistry
MH  - Capillary Permeability/drug effects
MH  - Cytokines/blood/genetics
MH  - Disease Models, Animal
MH  - Hemodynamics/drug effects
MH  - Inflammation Mediators/blood
MH  - Kidney/drug effects/physiopathology
MH  - Lipopolysaccharides
MH  - Lung/*drug effects/metabolism
MH  - Male
MH  - Methyl Ethers/*administration & dosage
MH  - Oxygen/*blood
MH  - Pneumonia/blood/chemically induced/physiopathology/*prevention & control
MH  - Propofol/*administration & dosage
MH  - Rats, Wistar
MH  - Respiration, Artificial
MH  - Sevoflurane
MH  - Time Factors
EDAT- 2016/10/27 06:00
MHDA- 2017/07/14 06:00
CRDT- 2016/10/27 06:00
PHST- 2016/10/27 06:00 [pubmed]
PHST- 2017/07/14 06:00 [medline]
PHST- 2016/10/27 06:00 [entrez]
AID - 10.1213/ANE.0000000000001530 [doi]
PST - ppublish
SO  - Anesth Analg. 2017 Jan;124(1):194-203. doi: 10.1213/ANE.0000000000001530.