Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Acta Anaesthesiol Scand. 2011 Apr;55(4):401-10. doi: 10.1111/j.1399-6576.2011.02406.x.
Isoflurane is a common anesthetic agent used in human surgery and in animal models of sepsis. It has been suggested to have beneficial anti-inflammatory properties and to protect kidney function. Here, we investigated the effect of isoflurane on the development of kidney injury and dysfunction during 48-h endotoxemia in sheep.
Before the experiments, the sheep (n=16) were surgically equipped with transit-time flowprobes around the renal, femoral and superior mesenteric artery. The animals were randomized to either be anesthetized with isoflurane and mechanically ventilated or to remain conscious while they received intravenous Escherichia coli lipopolysaccharide (LPS) for 48 h (25 ng/kg/min). In two animals in each group, the LPS was excluded to investigate any effect of isoflurane per se over time.
Endotoxemia caused cardiovascular changes typical for hyperdynamic sepsis and, although renal hyperemia occurred, impaired renal function in both groups. Compared with conscious animals, isoflurane significantly (P<0.05) reduced urine output, renal creatinine clearance, fractional sodium excretion and renal blood flow during endotoxemia. Furthermore, the plasma concentrations of urea and creatinine increased more in the anesthetized animals. Isoflurane anesthesia also enhanced neutrophil activity and accumulation in the kidney during endotoxemia. N-acetyl-β-D-glucosaminidase was significantly increased, with no inter-group difference as an indication of tubular injury.
The results of the current study suggest that isoflurane anesthesia (minimum alveolar concentration 1.0) with mechanical ventilation aggravates renal dysfunction during 48 h of endotoxemia and does not significantly reduce the inflammatory response or signs of tubular damage.
异氟烷是一种常用于人类手术和脓毒症动物模型的常用麻醉剂。它具有抗炎作用，可保护肾功能。在这里，我们研究了异氟烷对绵羊内毒素血症 48 小时期间肾损伤和功能障碍发展的影响。
在实验前，将绵羊（n=16）用瞬态血流探头环绕肾动脉、股动脉和肠系膜上动脉进行手术装备。将动物随机分为异氟烷麻醉和机械通气组，或保持清醒并在 48 小时内静脉输注大肠杆菌脂多糖（LPS）（25 ng/kg/min）。在每组中的 2 只动物中，排除 LPS 以研究异氟烷本身随时间的任何影响。
内毒素血症引起类似于高动力性脓毒症的心血管变化，尽管发生了肾充血，但两组的肾功能均受损。与清醒动物相比，异氟烷麻醉在整个内毒素血症期间显著（P<0.05）降低了尿量、肾肌酐清除率、钠排泄分数和肾血流量。此外，麻醉动物的血浆尿素和肌酐浓度增加更多。异氟烷麻醉还增强了内毒素血症期间肾脏中性粒细胞的活性和积聚。N-乙酰-β-D-氨基葡萄糖苷酶显著增加，无组间差异，表明肾小管损伤。
当前研究的结果表明，机械通气的异氟烷麻醉（最低肺泡浓度 1.0）在 48 小时的内毒素血症期间加重了肾功能障碍，并且没有显著减轻炎症反应或肾小管损伤的迹象。
