Pulmonary clearance of 99mTc‐DTPA during halothane anaesthesia

Wollmer, Per; Schairer, W.; Bos, J. A. H.; Bakker, Willem H.; Krenning, E. P.; Lachmann, Burkhard

doi:10.1111/j.1399-6576.1990.tb03147.x

Cited by 38 publications

(13 citation statements)

References 18 publications

(17 reference statements)

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“…The mechanisms whereby halothane induced a decrease in sodium transport protein activity have not been yet elucidated but are not related in vitro to a decrease in intracellular ATP content or to change in cytosolic free calcium. Also, some studies show that halothane increases permeability of alveolar capillary barrier to both water and protein as measured by the pulmonary clearance of 99m TcDTPA in both rabbit (384) and humans (58). Taken together, these observations suggest that halogenated anesthetics may interfere with the clearance of alveolar edema.…”

Section: Anestheticsmentioning

confidence: 99%

Lung Epithelial Fluid Transport and the Resolution of Pulmonary Edema

Matthay

Folkesson²,

Clérici³

2002

Physiological Reviews

610

649

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The discovery of mechanisms that regulate salt and water transport by the alveolar and distal airway epithelium of the lung has generated new insights into the regulation of lung fluid balance under both normal and pathological conditions. There is convincing evidence that active sodium and chloride transporters are expressed in the distal lung epithelium and are responsible for the ability of the lung to remove alveolar fluid at the time of birth as well as in the mature lung when pathological conditions lead to the development of pulmonary edema. Currently, the best described molecular transporters are the epithelial sodium channel, the cystic fibrosis transmembrane conductance regulator, Na+-K+-ATPase, and several aquaporin water channels. Both catecholamine-dependent and -independent mechanisms can upregulate isosmolar fluid transport across the distal lung epithelium. Experimental and clinical studies have made it possible to examine the role of these transporters in the resolution of pulmonary edema.

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Section: Anestheticsmentioning

confidence: 99%

Lung Epithelial Fluid Transport and the Resolution of Pulmonary Edema

Matthay

Folkesson²,

Clérici³

2002

Physiological Reviews

610

649

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“…The tmax for S-salbutamol, as well as for R-salbutamol, was found to be about twice as high after endotracheal administration as after an inhaled administration. In contrast to the findings during general anaesthesia, a tmax was already recorded within a few minutes after a canister of salbutamol metered-dose inhaler (MDI) was actuated via an intratracheal catheter in rabbits anaesthetized by halothane and ventilated with 100% O 2 [17]. It is not known whether the latter findings were influenced by dysfunction of surfactant, presumably depleted by halothane in combination with 100% O 2 , or whether this was a combined effect of induced epithelial damage [18].…”

Section: Discussionmentioning

confidence: 93%

Colony-stimulating factor therapy and febrile neutropenia induced by chemotherapy: need for economical studies

Urban¹,

Lebeau²

1999

Eur Respir J

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Racemic R,S-salbutamol is taken to relieve bronchial constriction. Only the R-enantiomer has bronchodilating properties. The S-enantiomer has been proposed to cause in vitro bronchial hyperreactivity in guinea-pigs. Stereoselective elimination of salbutamol has been shown, with S-salbutamol being eliminated at a slower rate than R-salbutamol. This study questioned whether rates of stereoselective elimination were similar after oral or lung delivery, and whether the S:R ratio would increase after repeated inhalations in a situation resembling a common clinical use.Eighteen healthy volunteers received single-dose racemic salbutamol as a solution instilled in the trachea during anaesthesia, as inhaled micronized powder and/or as ingested tablets. Five volunteers inhaled repeated doses of racemic salbutamol. Concentrations in plasma and urine were measured using a technique which allowed chiral separation of samples with concentrations as low as 0.1 ng . mL -1 . The bioavailability of S-salbutamol was significantly higher than that of R-salbutamol after the different modes of administration. Stereoselective elimination was more pronounced after oral administration than after inhalation. Repeated inhalations resulted in successive increases in the S:R ratio as steady state was approached.In conclusion, the clinical consequences of increasing plasma concentrations of Ssalbutamol need to be further assessed. Eur Respir J 1999; 13: 1230±1235. Many drugs are formulated as racemic mixtures and it has become clear that the enantiomers may differ in their pharmacokinetic and pharmacodynamic properties. There are numerous examples of enantioselective differences [1], and single enantiomers have taken the place of racemic drugs in several areas of medicine. Salbutamol (albuterol) is a sympathomimetic drug, with potent b 2 -adrenoceptor stimulating properties. Racemic R,S-salbutamol is taken for the relief of reversible bronchoconstriction and the therapeutic activity is associated with the R-enantiomer [2±4]. S-salbutamol has been demonstrated to cause increased airway responsiveness to carbachol in vitro and in vivo (in guinea-pigs) [5,6]. Previously it has been shown that metabolism occurs in both airways and the gastrointestinal tract by stereoselective sulphate conjugation [7]. The rate by which the bronchodilating R-enantiomer is sulphated greatly exceeds that of the S-enantiomer in vitro [8]. Unchanged R-and S-salbutamol is excreted in urine [9]. Stereoselective elimination has been reported after administration of the racemate by oral [3, 10], intravenous or rectal routes [9], findings that were also supported by in vitro experiments [11,12]. These observations indicate a more efficient removal of the active bronchodilating R-enantiomer, exposing the body to higher concentrations of the S-enantiomer. Repeated dosing could then lead to a greater ratio of S:R salbutamol in the blood over time. Assuming that adverse effects are associated with S-salbutamol in humans, the clinical implication of stereoselective d...

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“…(18) and systemic diseases such as Behçet's disease (19) have caused increased lung clearance of Tc-99m DTPA. Some researchers have found significantly rapid pulmonary clearance of Tc-99m DTPA in rabbits under general anesthesia with high oxygen concentrations (79%) (20,21). Therefore, the more rapid pulmonary clearance of Tc-99m DTPA in patients who received desflurane and sevoflurane could be due to the effects of inhaler anesthetics rather than oxygen.…”

Section: Discussionmentioning

confidence: 99%

“…These researchers found no significant change in alveolar epithelial permeability before surgery and after surgery (22). Wollmer et al (21) showed that halothane, in combination with high oxygen concentrations, increases the permeability of the alveolarcapillary barrier. However, in our study, during the maintenance of anesthesia, all patients were mechanically ventilated with low oxygen (40% oxygen).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effects of desflurane and sevoflurane anesthesia on alveolar epithelial permeability by Tc-99m DTPA inhalation scintigraphy

Iskender¹,

Erkan²,

Erbaş³

et al. 2013

Turk J Med Sci

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Eight new mono-azo substituted chromogenic calix [4]arenes (1-8) were synthesized by diazo-coupling reactions in which 25,26,27-tribenzoyloxy-28-hydroxy-5,11,17-tri-(tert -butyl)calix[4]arene and diazonium salts (2-, 3-, and 4-nitroaniline; 4-phenyl azoaniline; 3-and 4-chloroaniline; or 2-and 4-methylaniline) formed the corresponding mono-azo substituted derivatives in high yields. The mono-azo substituted calix[4]arenes were characterized by UV-Vis, FT-IR, and 1 H-NMR spectroscopic techniques. Elemental analysis was also carried out. In addition, the effects of varying pH levels and solvents upon the absorption ability of azocalix[4]arenes substituted with electron-donating and electron-withdrawing groups at their o -, m -, and ppositions were studied. The results proved that the absorption maxima of the prepared compounds showed large bathochromic effects in comparison with analog compounds containing aromatic amine residue. Furthermore, concentration effects on the visible absorption maxima of the azocalix[4]arene compounds studied were also reported.

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Pulmonary clearance of 99mTc‐DTPA during halothane anaesthesia

Cited by 38 publications

References 18 publications

Lung Epithelial Fluid Transport and the Resolution of Pulmonary Edema

Lung Epithelial Fluid Transport and the Resolution of Pulmonary Edema

Colony-stimulating factor therapy and febrile neutropenia induced by chemotherapy: need for economical studies

Evaluation of the effects of desflurane and sevoflurane anesthesia on alveolar epithelial permeability by Tc-99m DTPA inhalation scintigraphy

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