Sevoflurane Protects against Acute Kidney Injury in a Small-Size Liver Transplantation Model

Kong, Hanjing; Zhu, Shengmei; Wang, L Q; He, Yong; Xie, Haiyang; Zheng, Shusen

doi:10.1159/000319623

Cited by 38 publications

(36 citation statements)

References 54 publications

(46 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[8][9][10] Many studies have demonstrated that sevoflurane can modulate inflammatory cascades and has protective effects against ischemia/reperfusion injury. [11][12][13] Studies by Suter et al 11 demonstrated a decrease in the production of inflammatory proteins in alveolar epithelial cells with sevoflurane preconditioning in endotoxin-induced lung injury.…”

Section: Introductionmentioning

confidence: 99%

Sevoflurane attenuates pulmonary inflammation and ventilator-induced lung injury by upregulation of HO-1 mRNA expression in mice

Xiong¹,

Lin²,

Wang³

2013

IJN

View full text Add to dashboard Cite

Background: Mechanical ventilation has been documented to paradoxically cause lung injury. As a commonly used volatile anesthetic, sevoflurane has been proven to possess antiinflammatory and antioxidative properties. This study aims to investigate the protective effects of sevoflurane on inflammation and ventilator-induced lung injury during mechanical ventilation in healthy mice. Methods: The adult healthy mice were divided into four groups, each consisting of ten subjects: mice in group Con-L VT and group Sev-L VT were ventilated with tidal volumes of 8 mL/kg for 4 hours, while those in group Con-H VT and group Sev-H VT were ventilated with tidal volumes of 16 mL/kg instead. Control mice (group Con-L VT and Con-H VT ) were subjected to fresh air, while sevoflurane-treated mice (groups Sev-L VT and Sev-H VT ) were subjected to air mixed with 1 vol% sevoflurane. After 4 hours of ventilation, the bronchoalveolar lavage (BAL) fluid was collected and analyzed for the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-10. Lung homogenates were harvested to detect the expression of nuclear factorkappa B (NF-κB) and heme oxygenase (HO)-1 mRNA by reverse transcription-polymerase chain reaction method. Lung damage was evaluated using the modified Ventilator-Induced Lung Injury histological scoring system. Results: Compared to group Con-L VT , the levels of TNF-α, IL-1β, IL-6, and IL-10 in BAL fluid, mRNA expressions of NF-κB and HO-1 in lung tissue, and lung injury scores were significantly increased in group Con-H VT ; compared to group Con-H VT , group Sev-H VT BAL samples showed decreased levels of TNF-α, IL-1β, and IL-6; they also showed increased levels of IL-10, the downregulation of NF-κB mRNA, and HO-1 mRNA upregulation; the lung injury scores were significantly lower in group Sev-H VT than group Con-H VT . Conclusion: Mechanical ventilation with high tidal volume might lead to lung injury, which could be significantly, but not completely, attenuated by sevoflurane inhalation by inhibiting the NF-κB-mediated proinflammatory cytokine generation and upregulating HO-1 expression.

show abstract

Section: Introductionmentioning

confidence: 99%

Sevoflurane attenuates pulmonary inflammation and ventilator-induced lung injury by upregulation of HO-1 mRNA expression in mice

Xiong¹,

Lin²,

Wang³

2013

IJN

View full text Add to dashboard Cite

show abstract

“…Both propofol and sevoflurane are anti-inflammatory agents because they decrease the production of the nuclear transcription factor (NF-kB) 15,22, which is considered a transcriptional inducer of pro-inflammatory interleukins, such as interleukins 1 and 6 23 and of NGAL itself 24. Through different mechanisms, both sevoflurane and propofol exert protective effects on the kidneys: propofol decreased the tissue damage caused by oxidative stress 25 and in renal ischemia models, sevoflurane provided pharmacological preconditioning 15,26. However, there has been no consensus in the literature regarding the more effective drug for kidney protection.…”

Section: Discussionmentioning

confidence: 99%

“…Though different mechanisms, both propofol 14 and sevoflurane 15 have appeared to reduce renal injury in clinical-surgical and experimental injury models. Various markers are measured serially to monitor kidney injury during the perioperative period, but many of these markers are delayed, or they have sensitivity limitations.…”

Section: Introductionmentioning

confidence: 99%

General anesthesia type does not influence serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in video laparoscopic bariatric surgery

Fernandes¹,

Ettinger²,

Amaral³

et al. 2014

Clinics

View full text Add to dashboard Cite

OBJECTIVES:Video laparoscopic bariatric surgery is the preferred surgical technique for treating morbid obesity. However, pneumoperitoneum can pose risks to the kidneys by causing a decrease in renal blood flow. Furthermore, as in other surgical procedures, laparoscopic bariatric surgery triggers an acute inflammatory response. Neutrophil gelatinase-associated lipocalin is an early and accurate biomarker of renal injury, as well as of the inflammatory response. Anesthetic drugs could offer some protection for the kidneys and could attenuate the acute inflammatory response from surgical trauma. The objective of this study was to compare the effects of two types of anesthetics, propofol and sevoflurane, on the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery.METHODS:Sixty-four patients scheduled for laparoscopic bariatric surgery were randomized into two anesthesia groups and were administered either total intravenous anesthesia (propofol) or inhalation anesthesia (sevoflurane). In the perioperative period, blood samples were collected at three time points (before anesthesia, 6 hours after pneumoperitoneum and 24 hours after pneumoperitoneum) and urine output was measured for 24 hours. Acute kidney injuries were evaluated by examining both the clinical and laboratory parameters during the postoperative period. The differences between the groups were compared using non-parametric tests. ReBEC (http://www.ensaiosclinicos.gov.br/rg/recruiting/): RBR-8wt2fyRESULTS:None of the patients developed an acute kidney injury during the study and no significant differences were found between the serum neutrophil gelatinase-associated lipocalin levels of the groups during the perioperative period.CONCLUSION:The choice of anesthetic drug, either propofol or sevoflurane, did not affect the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery.

show abstract

“…A study of sevofl urane eff ects on renal function in rats after liver transplantation demonstrated signifi cantly reduced NGAL concentrations in the sevofl urane group, as well as smaller epithelial necrosis. In the group anesthetized with sevofl urane, signifi cantly lower serum concentrations of TNF-a, IL-6, and myeloperoxidase were found 2 hours after reperfusion 23 . In parallel with the increase in the number of studies demonstrating the protective role of sevofl urane against the occurrence of AKI, there is also a large number of studies on the protective eff ects of other anesthetics, such as propofol, with regard to AKI.…”

Section: Modulation Of Ischemia/reperfusion Injury and Anti-infl Ammamentioning

confidence: 94%

Effect of Inhalational Anesthetics on Acute Kidney Injury

Bublić

Tonković

Sakan³

et al. 2016

acc

View full text Add to dashboard Cite

SUMMARY -Acute kidney injury (AKI) is a serious complication associated with increased morbidity and mortality. Total incidence of AKI in hospitalized patients is 1%-5%. As many as 30% of these patients develop AKI in the perioperative period, which is associated with anesthesia and surgery. Despite scientifi c advances and improved surgery techniques, as well as treatment in intensive care units, no signifi cant decrease in AKI incidence has been achieved. To change this outcome, it is important to identify patients at risk of AKI and prevent its occurrence. Correct selection of anesthetic drugs during general anesthesia, adjusted to the individual needs of patients, also infl uences the overall outcome of treatment. Nowadays, inhalational anesthetics are not considered nephrotoxic. Th e more so, inhalational anesthetics have a strong and direct protective eff ect on many organs through preconditioning and postconditioning. New studies have shown that sevofl urane diminishes ischemia/ reperfusion kidney injury and has an anti-infl ammatory eff ect, thus having the potential to reduce the occurrence of AKI. Given the incidence of AKI in the perioperative period, as well as new fi ndings about anesthetics, the issue of anesthetic selection during general anesthesia might be of crucial importance for the fi nal outcome of treatment.

show abstract

Sevoflurane Protects against Acute Kidney Injury in a Small-Size Liver Transplantation Model

Cited by 38 publications

References 54 publications

Sevoflurane attenuates pulmonary inflammation and ventilator-induced lung injury by upregulation of HO-1 mRNA expression in mice

Sevoflurane attenuates pulmonary inflammation and ventilator-induced lung injury by upregulation of HO-1 mRNA expression in mice

General anesthesia type does not influence serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in video laparoscopic bariatric surgery

Effect of Inhalational Anesthetics on Acute Kidney Injury

Contact Info

Product

Resources

About