Influence of propofol and volatile anaesthetics on the inflammatory response in the ventilated lung

Kalimeris, Konstantinos; Christodoulaki, Kalliopi; Karakitsos, Petros; Batistatou, Anna; Lekka, Marilena E.; Bai, Maria; Kitsiouli, Eirini; Νάκος, Γεώργιος; Kostopanagiotou, Georgia

doi:10.1111/j.1399-6576.2011.02461.x

Cited by 38 publications

(18 citation statements)

References 35 publications

(44 reference statements)

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“…47 In contrast, several other studies show that halogenated anesthesia attenuates the inflammatory response. 48,49 Another recent study, concerning the inflammatory response in major abdominal surgery, reveals that there are no statistically significant differences between total intravenous anesthesia and inhalational anesthesia.…”

Section: Perioperative Medicinementioning

confidence: 70%

Protective Mechanical Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function

et al. 2013

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Background: The impact of intraoperative ventilation on postoperative pulmonary complications is not defined. The authors aimed at determining the effectiveness of protective mechanical ventilation during open abdominal surgery on a modified Clinical Pulmonary Infection Score as primary outcome and postoperative pulmonary function. Methods: Prospective randomized, open-label, clinical trial performed in 56 patients scheduled to undergo elective open abdominal surgery lasting more than 2 h. Patients were assigned by envelopes to mechanical ventilation with tidal volume of 9 ml/kg ideal body weight and zero-positive end-expiratory pressure (standard ventilation strategy) or tidal volumes of 7 ml/kg ideal body weight, 10 cm H2O positive end-expiratory pressure, and recruitment maneuvers (protective ventilation strategy). Modified Clinical Pulmonary Infection Score, gas exchange, and pulmonary functional tests were measured preoperatively, as well as at days 1, 3, and 5 after surgery. Results: Patients ventilated protectively showed better pulmonary functional tests up to day 5, fewer alterations on chest x-ray up to day 3 and higher arterial oxygenation in air at days 1, 3, and 5 (mmHg; mean ± SD): 77.1 ± 13.0 versus 64.9 ± 11.3 (P = 0.0006), 80.5 ± 10.1 versus 69.7 ± 9.3 (P = 0.0002), and 82.1 ± 10.7 versus 78.5 ± 21.7 (P = 0.44) respectively. The modified Clinical Pulmonary Infection Score was lower in the protective ventilation strategy at days 1 and 3. The percentage of patients in hospital at day 28 after surgery was not different between groups (7 vs. 15% respectively, P = 0.42). Conclusion: A protective ventilation strategy during abdominal surgery lasting more than 2 h improved respiratory function and reduced the modified Clinical Pulmonary Infection Score without affecting length of hospital stay.

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Section: Perioperative Medicinementioning

confidence: 70%

Protective Mechanical Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function

et al. 2013

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“…In a ventilated pig model, sevoflurane and desflurane were shown to decrease macrophage levels in bronchial alveolar fluid, and the overall cellular infiltration was also reduced. 28 Isoflurane at 1.0 MAC after LPS exposure decreased macrophage release of TNF-α and IL-1β. 27 Sevoflurane decreased cytokine release, specifically IL-6, IL-8, and IL-10, in patients undergoing cardiac surgery.…”

Section: Innate Immunitymentioning

confidence: 88%

Immune Modulation by Volatile Anesthetics

et al. 2016

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Volatile general anesthetics continue to be an important part of clinical anesthesia worldwide. The impact of volatile anesthetics on the immune system has been investigated at both mechanistic and clinical levels, but previous studies have returned conflicting findings due to varied protocols, experimental environments, and subject species. While many of these studies have focused on the immunosuppressive effects of volatile anesthetics, compelling evidence also exists for immunoactivation. Depending on the clinical conditions, immunosuppression and activation due to volatile anesthetics can be either detrimental or beneficial. This review provides a balanced perspective on the anesthetic modulation of innate and adaptive immune responses as well as indirect effectors of immunity. Potential mechanisms of immunomodulation by volatile anesthetics are also discussed. A clearer understanding of these issues will pave the way for clinical guidelines that better account for the impact of volatile anesthetics on the immune system, with the ultimate goal of improving perioperative management.

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“…As a widely used intravenous anesthetic clinically [25,26], propofol has been reported to possess its anti-inflammatory effects, however, the mechanism of its action is still not understood yet. Clinically, 3-11 lg/ml (correspond to 17-62 lM) blood concentration of propofol can satisfy the anesthesia depth.…”

Section: Discussionmentioning

confidence: 98%

Anti-inflammatory Effects of Propofol on Lipopolysaccharides-Treated Rat Hepatic Kupffer Cells

Wang

Liu

et al. 2014

Cell Biochem Biophys

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This study is set to explore the role of commonly used intravenous anesthetic propofol on the inflammatory response of rat liver Kupffer cells (KCs) induced by lipopolysaccharides (LPS). The isolated KCs were cultured at the density of 1 × 10(5)/ml, divided into five groups randomly after 48 h culture: group C, control group; group L, KCs were treated with 1 μg/ml LPS for 24 h; groups P1, P2, P3, KCs were pretreated with propofol at low (25 μM), medium (50 μM), high (100 μM) concentration for 2 h, respectively, and then were stimulated with 1 μg/ml LPS for 24 h. The expressions of tumor necrosis factor-α (TNF-α) mRNA and interleukin-1β (IL-1β) mRNA of every group were measured by RT-PCR. Nuclear NF-ΚB p65 was determined by Western blot. The concentrations of IL-1β and TNF-α in supernatant were measured by ELISA. Compared with the group C, TNF-α mRNA and IL-1β mRNA in group L were significantly up-regulated and NF-ΚB p65 was significantly up-regulated after LPS treatment (P < 0.05). Meanwhile, TNF-α and IL-1β were also significantly increased (P < 0.05). With propofol the mRNA expressions of aforementioned inflammatory mediators were significantly down-regulated and NF-ΚB p65 was significantly inhibited in group P2 and P3 (P < 0.05), compared with group L. However, low propofol concentration did not exhibit any effect (group P1, P > 0.05). Propofol at medium and high concentration can counteract the LPS-induced inflammatory response in KCs by regulating NF-ΚB p65 protein expression.

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Influence of propofol and volatile anaesthetics on the inflammatory response in the ventilated lung

Cited by 38 publications

References 35 publications

Protective Mechanical Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function

Protective Mechanical Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function

Immune Modulation by Volatile Anesthetics

Anti-inflammatory Effects of Propofol on Lipopolysaccharides-Treated Rat Hepatic Kupffer Cells

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