Impairment of gas exchange due to alveolar oedema during xylazine sedation in sheep; absence of a free radical mediated inflammatory mechanism

Bacon, Pamela; Jones, J.G.; Taylor, P.; Stewart, Susan; Wilson-Nunn, D.; Kerr, Mark E.

doi:10.1016/s0034-5288(98)90030-3

Cited by 29 publications

(47 citation statements)

References 7 publications

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“…Several mechanisms have been proposed for α 2 ‐agonist‐induced hypoxemia in sheep, including intense venous spasm mediated via adrenoreceptor agonism, pulmonary congestion and alveolar capillary rupture, culminating in an inflammatory response (Bacon et al. ; Kästner et al. ).…”

Section: Discussionmentioning

confidence: 99%

“…Hypoxemia is often observed in sheep after administration of dexmedetomidine, even with low doses, although there may be variation among individuals (K€ astner 2006; K€ astner et al 2007). Several mechanisms have been proposed for a 2 -agonist-induced hypoxemia in sheep, including intense venous spasm mediated via adrenoreceptor agonism, pulmonary congestion and alveolar capillary rupture, culminating in an inflammatory response (Bacon et al 1998;K€ astner et al 2007). In the present study, there were significant reductions in PaO 2 , but the magnitude of the changes differed between animals.…”

Section: Variable/ Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Behavioral and cardiopulmonary effects of dexmedetomidine alone and in combination with butorphanol, methadone, morphine or tramadol in conscious sheep

Borges

Nishimura

Carvalho

et al. 2016

Veterinary Anaesthesia and Analgesia

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Section: Discussionmentioning

confidence: 99%

Section: Variable/ Treatmentmentioning

confidence: 99%

Behavioral and cardiopulmonary effects of dexmedetomidine alone and in combination with butorphanol, methadone, morphine or tramadol in conscious sheep

Borges

Nishimura

Carvalho

et al. 2016

Veterinary Anaesthesia and Analgesia

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“…However, more recent data suggests that clonidine may cause mild respiratory depression in humans [9], and α 2 -adrenoceptor agonists are well known to produce profound intraoperative hypoxaemia in sheep [10,11]. The effects of dexmedetomidine on other ventilation parameters also appear to be species specific [12].…”

Section: Discussionmentioning

confidence: 99%

Respiratory effects of dexmedetomidine in the surgical patient requiring intensive care

2000

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The respiratory effects of dexmedetomidine were retrospectively examined in 33 postsurgical patients involved in a randomised, placebo-controlled trial after extubation in the intensive care unit (ICU). Morphine requirements were reduced by over 50% in patients receiving dexmedetomidine. There were no differences in respiratory rates, oxygen saturations, arterial pH and arterial partial carbon dioxide tension (PaCO 2 ) between the groups. Interestingly the arterial partial oxygen tension (PaO 2 ) : fractional inspired oxygen (FIO 2 ) ratios were statistically significantly higher in the dexmedetomidine group. Dexmedetomidine provides important postsurgical analgesia and appears to have no clinically important adverse effects on respiration in the surgical patient who requires intensive care. Introduction:The α 2 -agonist dexmedetomidine is a new class of sedative drug that is being investigated for use in ICU settings. It is an effective agent for the management of sedation and analgesia after cardiac, general, orthopaedic, head and neck, oncological and vascular surgery in the ICU [1]. Cardiovascular stability was demonstrated, with significant reductions in rate-pressure product during sedation and over the extubation period. Dexmedetomidine possesses several properties that may additionally benefit those critically ill patients who require sedation. In spontaneously breathing volunteers, intravenous dexmedetomidine caused marked sedation with only mild reductions in resting ventilation at higher doses [2]. Dexmedetomidine reduces the haemodynamic response to intubation and extubation [3][4][5] and attenuates the stress response to surgery [6], as a result of the α 2 -mediated reduction in sympathetic tone. Therefore, it should be possible to continue sedation with dexmedetomidine over the stressful extubation period without concerns over respiratory depression, while ensuring that haemodynamic stability is preserved. The present study is a retrospective analysis of the respiratory response to dexmedetomidine in 33 postsurgical patients (who were involved in a randomized, double-blind, placebocontrolled trial [1]) after extubation in the ICU. Methods: Patients who participated in the present study were admitted after surgery to our general or cardiothoracic ICUs, and were expected to receive at least 6 h of postsurgical sedation and artificial ventilation. On arrival in the ICU after surgery, patients were randomized to receive either dexmedetomidine or placebo (normal saline) with rescue sedation and analgesia being provided, only if clinically needed, with midazolam and morphine boluses, respectively. Sedation was titrated to maintain a Ramsay Sedation Score [7] of 3 or greater while the patients were intubated, and infusions of http://ccforum.com/content/4/5/302 http://ccforum.com/content/4/5/302 study drug were continued for a maximum of 6 h after extubation to achieve a Ramsay Sedation Score of 2 or greater. The patients were intubated and ventilated with oxygenenriched air to attain acceptable arterial ...

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“…The pathogenesis of these phenomena is uncertain (Raptopoulos et al. 1995; Bacon et al. 1998; Celly et al.…”

Section: Discussionmentioning

confidence: 99%

“…1999b) which involves stimulation of intravascular pulmonary macrophages, platelet aggregation and pulmonary hypertension after vasoconstriction of post‐capillary venules (Eisenach 1988; Raptopoulos et al. 1995; Bacon et al. 1998; Celly et al.…”

Section: Discussionmentioning

confidence: 99%

Comparison of two pre-anaesthetic medetomidine doses in isoflurane anaesthetized sheep

Kästner

Kutter

Rechenberg

et al. 2006

Veterinary Anaesthesia and Analgesia

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Impairment of gas exchange due to alveolar oedema during xylazine sedation in sheep; absence of a free radical mediated inflammatory mechanism

Cited by 29 publications

References 7 publications

Behavioral and cardiopulmonary effects of dexmedetomidine alone and in combination with butorphanol, methadone, morphine or tramadol in conscious sheep

Behavioral and cardiopulmonary effects of dexmedetomidine alone and in combination with butorphanol, methadone, morphine or tramadol in conscious sheep

Respiratory effects of dexmedetomidine in the surgical patient requiring intensive care

Comparison of two pre-anaesthetic medetomidine doses in isoflurane anaesthetized sheep

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