Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, People's Republic of China.
Shock. 2010 Aug;34(2):183-9. doi: 10.1097/SHK.0b013e3181cffc3f.
Multiple organ dysfunction syndrome (MODS) is one of the leading causes of death in the intensive care unit. Organ failure especially lung injury is highly associated with the mortality for MODS patients. Volatile anesthetic isoflurane (ISO) is one of the most widely used anesthetic agents, and ISO anesthesia has been reported to improve the survival rate and organ function in sepsis/MODS models. However, the application of anesthetic dose ISO in critically ill patients is limited. Compared with i.v. anesthetic pentobarbital treatment, we showed that twice inhalation of ISO at subanesthetic dose (0.7%, 0.5 minimum alveolar concentration) alleviated lung injury at 24 h after zymosan (ZY) injection and increased the 7-day survival rate from 10% to 45% in mice. We also showed that ISO exerted its protection by significantly improving the activities of superoxide dismutase and catalase in lung and serum when compared with those in pentobarbital-treated mice. The catalase inhibitor 3-amino-1, 2, 4-triazole partially abolished the protective effect of ISO in ZY-challenged mice. We conclude that subanesthetic dose ISO protects against ZY-induced generalized inflammation and its associated lung injury via enhancing the activities of antioxidant enzymes in mice, which may provide a new strategy for the treatment of critically ill patients.
多器官功能障碍综合征（MODS）是重症监护病房（ICU）死亡的主要原因之一。器官衰竭，特别是肺损伤，与 MODS 患者的死亡率高度相关。挥发性麻醉剂异氟醚（ISO）是最广泛使用的麻醉剂之一，有报道称 ISO 麻醉可提高脓毒症/MODS 模型的存活率和器官功能。然而，在危重病患者中应用 ISO 麻醉剂的剂量受到限制。与静脉麻醉剂戊巴比妥治疗相比，我们发现，亚麻醉剂量（0.7%，0.5 最低肺泡浓度）的 ISO 两次吸入可减轻酵母聚糖（ZY）注射后 24 小时的肺损伤，并将 7 天存活率从 10%提高到 45%在小鼠中。我们还表明，与戊巴比妥治疗的小鼠相比，ISO 通过显著提高肺和血清中超氧化物歧化酶和过氧化氢酶的活性来发挥其保护作用。过氧化氢酶抑制剂 3-氨基-1,2,4-三唑部分消除了 ISO 在 ZY 挑战小鼠中的保护作用。我们得出结论，亚麻醉剂量的 ISO 通过增强抗氧化酶的活性来保护小鼠免受 ZY 诱导的全身性炎症及其相关的肺损伤，这可能为危重病患者的治疗提供新策略。
