• Eur J Anaesthesiol · Aug 2013

    Sevoflurane, but not propofol, reduces the lung inflammatory response and improves oxygenation in an acute respiratory distress syndrome model: a randomised laboratory study.

    • Carlos Ferrando, Gerardo Aguilar, Laura Piqueras, Marina Soro, Joaquin Moreno, and Francisco J Belda.
    • Department of Anesthesiology and Intensive Care, Fundación de Investigación (INCLIVA), Hospital Clínico Universitario de Valencia, Valencia, Spain.
    • Eur J Anaesthesiol. 2013 Aug 1;30(8):455-63.

    ContextAcute respiratory distress syndrome is characterised by activation of the inflammatory cascade. The only treatment that reduces the mortality rate associated with this syndrome is lung protective ventilation, which requires sedation of patients. Sedation in critical care units is usually induced intravenously, although there is reason to believe that inhaled anaesthetics are a suitable alternative. Sevoflurane has recently been shown to modulate the lung inflammatory response in a model of lung injury more favourably than propofol.ObjectiveThe goal of this study was to confirm whether or not sevoflurane is more effective than propofol in ameliorating the inflammatory response in an animal model of acute respiratory distress syndrome.DesignA prospective, randomised, controlled study.SettingResearch foundation laboratory at the Hospital Clínico Universitario, Valencia, Spain.Experimental AnimalsSixteen Landrace/large white crossbred pigs weighing 30 to 45 kg.InterventionsAnimals were allocated randomly to one of two groups: one sedated with intravenous propofol 5 to 7 mg kg h (group P) and the other with sevoflurane, administered using an AnaConDa device to obtain an end-tidal concentration of 1.5% (group S). Monitoring, lung protective ventilation and anaesthetic management were identical in both groups.Main Outcome MeasuresThe PaO2/FiO2 ratio and cytokine concentrations in bronchoalveolar lavage specimens were determined at 10, 150 and 240 min after confirmation of acute respiratory distress syndrome (PaO2/FiO2 <26.7 kPa).ResultsAt 240 min, median and interquartile range (IQR) concentrations of cytokines in bronchial lavage specimens in group S were lower than those in group P [interleukin-1β (IL-1β) 53, IQR 16-140 vs. 311, IQR 183-637 pg ml, P = 0.04; tumour necrosis factor-α 347, IQR 161-433 vs. 552, IQR 475-649 pg ml, P = 0.04; and IL-6 101, IQR 76-282 vs. 580, IQR 369-701 pg ml, P = 0.03]. The polymorphonuclear neutrophil count was also lower in group S (P = 0.007), which also had a higher PaO2/FiO2 ratio.Trial RegistrationGE-015/09.ConclusionIn an animal model of acute respiratory distress syndrome, sevoflurane ameliorates the lung inflammatory response and improves oxygenation to a greater extent than propofol.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…