缺血前吸入地氟烷会增加离体兔肺缺血再灌注诱导的血管渗漏。
Desflurane inhalation before ischemia increases ischemia-reperfusion-induced vascular leakage in isolated rabbit lungs.
作者信息
Oshima Yoshiaki, Sakamoto Seiji, Yamasaki Kazumasa, Mochida Shinsuke, Funaki Kazumi, Moriyama Naoki, Otsuki Akihiro, Endo Ryo, Nakasone Masato, Takahashi Shunsaku, Harada Tomomi, Minami Yukari, Inagaki Yoshimi
机构信息
Division of Anesthesiology and Critical Care Medicine, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori 683-8504 Japan.
出版信息
Springerplus. 2016 Nov 29;5(1):2031. doi: 10.1186/s40064-016-3741-9. eCollection 2016.
BACKGROUND
Isoflurane and sevoflurane protect lungs with ischemia-reperfusion (IR) injury. We examined the influence of desflurane on IR lung injury using isolated rabbit lungs perfused with a physiological salt solution.
METHODS
The isolated lungs were divided into three groups: IR, desflurane-treated ischemia-reperfusion (DES-IR), and ventilation/perfusion-continued control (Cont) groups (n = 6 per group). In the DES-IR group, inhalation of desflurane at 1 minimum alveolar concentration (MAC) was conducted in a stable 30-min phase. In the IR and DES-IR groups, ventilation/perfusion was stopped for 75 min after the stable phase. Subsequently, they were resumed. Each lung was placed on a balance, and weighed. Weight changes were measured serially throughout this experiment. The coefficient of filtration (K) was determined immediately before ischemia and 60 min after reperfusion. Furthermore, bronchoalveolar lavage fluid (BALF) was collected from the right bronchus at the completion of the experiment. After the completion of the experiment, the left lung was dried, and the lung wet-to-dry weight ratio (W/D) was calculated.
RESULTS
The K values at 60 min after perfusion were 0.40 ± 0.13 ml/min/mmHg/100 g in the DES-IR group, 0.26 ± 0.07 ml/min/mmHg/100 g in the IR group, and 0.22 ± 0.08 (mean ± SD) ml/mmHg/100 g in the Cont group. In the DES-IR group, the K at 60 min after the start of reperfusion was significantly higher than in the other groups. In the DES-IR group, W/D was significantly higher than in the Cont group. In the DES-IR group, the BALF concentrations of nitric oxide metabolites were significantly higher than in the other groups. In the DES-IR group, the total amount of vascular endothelial growth factor in BALF was significantly higher than in the Cont group.
CONCLUSIONS
The pre-inhalation of desflurane at 1 MAC exacerbates pulmonary IR injury in isolated/perfused rabbit lungs.
背景
异氟烷和七氟烷可保护肺免受缺血再灌注（IR）损伤。我们使用灌注生理盐溶液的离体兔肺研究了地氟烷对IR肺损伤的影响。
方法
将离体肺分为三组：IR组、地氟烷处理的缺血再灌注（DES-IR）组和通气/灌注持续对照组（Cont组）（每组n = 6）。在DES-IR组中，以1个最低肺泡浓度（MAC）吸入地氟烷，持续30分钟。在IR组和DES-IR组中，稳定期后停止通气/灌注75分钟。随后，恢复通气/灌注。将每只肺置于天平上称重。在整个实验过程中连续测量重量变化。在缺血前和再灌注60分钟后立即测定滤过系数（K）。此外，在实验结束时从右支气管收集支气管肺泡灌洗液（BALF）。实验结束后，将左肺干燥，计算肺湿重与干重之比（W/D）。
结果
DES-IR组灌注60分钟后的K值为0.40±0.13 ml/min/mmHg/100 g，IR组为0.26±0.07 ml/min/mmHg/100 g，Cont组为0.22±0.08（平均值±标准差）ml/mmHg/100 g。在DES-IR组中，再灌注开始60分钟后的K值显著高于其他组。在DES-IR组中，W/D显著高于Cont组。在DES-IR组中，BALF中一氧化氮代谢产物的浓度显著高于其他组。在DES-IR组中，BALF中血管内皮生长因子的总量显著高于Cont组。
结论
在离体/灌注兔肺中，预先吸入1 MAC的地氟烷会加重肺IR损伤。
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