Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
PLoS One. 2012;7(9):e44940. doi: 10.1371/journal.pone.0044940. Epub 2012 Sep 11.
Exhaled pentane, which is produced as a consequence of reactive oxygen species-mediated lipid peroxidation, is a marker of oxidative stress. Propofol is widely used as a hypnotic agent in intensive care units and the operating room. Moreover, this agent has been reported to inhibit lipid peroxidation by directly scavenging reactive oxygen species. In this study, using a porcine liver ischemia-reperfusion injury model, we have evaluated the hypothesis that high concentrations of breath pentane are related to adverse outcome and that propofol could reduce breath pentane and improve liver injury and outcome in swine in this situation.
METHODOLOGY/PRINCIPAL FINDINGS: Twenty male swine were assigned to two groups: propofol (n = 10) and chloral hydrate groups (n = 10). Hepatic ischemia was induced by occluding the portal inflow vessels. Ischemia lasted for 30 min, followed by reperfusion for 360 min. Exhaled and blood pentane concentrations in the chloral hydrate group markedly increased 1 min after reperfusion and then decreased to baseline. Breath and blood pentane concentrations in the propofol group increased 1 min after reperfusion but were significantly lower than in the chloral hydrate group. A negative correlation was found between breath pentane levels and survival in the chloral hydrate group. The median overall survival was 251 min after reperfusion (range 150-360 min) in the chloral hydrate group. All of the swine were alive in the propofol group.
Monitoring of exhaled pentane may be useful for evaluating the severity of hepatic ischemia-reperfusion injury and aid in predicting the outcome; propofol may improve the outcome in this situation.
呼气中的戊烷是活性氧物质介导的脂质过氧化反应的产物,是氧化应激的标志物。丙泊酚作为一种镇静剂,在重症监护病房和手术室中被广泛应用。此外,该药物已被报道可通过直接清除活性氧物质来抑制脂质过氧化。在这项研究中,我们使用猪肝脏缺血再灌注损伤模型,评估了以下假说:高浓度的呼气戊烷与不良结局相关,丙泊酚可降低呼气戊烷浓度,并改善这种情况下猪的肝损伤和结局。
方法/主要发现:20 头雄性猪被分为两组:丙泊酚组(n = 10)和水合氯醛组(n = 10)。通过阻断门静脉流入血管来诱导肝脏缺血。缺血持续 30 分钟,随后再灌注 360 分钟。水合氯醛组在再灌注 1 分钟后呼气和血液中的戊烷浓度显著增加,然后降至基线。丙泊酚组在再灌注 1 分钟后呼气和血液中的戊烷浓度增加,但明显低于水合氯醛组。水合氯醛组中呼气戊烷水平与存活率呈负相关。水合氯醛组的中位总存活率为再灌注后 251 分钟(范围为 150-360 分钟)。丙泊酚组的所有猪均存活。
监测呼气中的戊烷可能有助于评估肝脏缺血再灌注损伤的严重程度,并有助于预测结局;丙泊酚可能改善这种情况下的结局。