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Preconditioning, but not postconditioning, with Sevoflurane reduces pulmonary neutrophil accumulation after lower body ischaemia/reperfusion injury in rats

Published online by Cambridge University Press:  01 June 2008

R. Kalb ,
P. Schober ,
L. A. Schwarte ,
J. Weimann  and
S. A. Loer
R. Kalb
Affiliation:
Heinrich-Heine-University Düsseldorf, Department of Anaesthesiology, Düsseldorf, Germany
P. Schober*
Affiliation:
VU Medisch Centrum, Department of Anaesthesiology, Amsterdam, The Netherlands
L. A. Schwarte
Affiliation:
VU Medisch Centrum, Department of Anaesthesiology, Amsterdam, The Netherlands
J. Weimann
Affiliation:
VU Medisch Centrum, Department of Anaesthesiology, Amsterdam, The Netherlands
S. A. Loer
Affiliation:
VU Medisch Centrum, Department of Anaesthesiology, Amsterdam, The Netherlands
*
Correspondence to: Patrick Schober, Department of Anaesthesiology, VU Medisch Centrum, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. E-mail: P.Schober@vumc.nl; Tel: +31 (0) 20 444 3138; Fax: +31 (0) 20 444 4385
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Summary

Background and objectives

Aortic ischaemia and reperfusion may induce pulmonary sequestration of neutrophil granulocytes. Preconditioning and postconditioning with volatile anaesthetics confer protection against reperfusion injury in various organs, such as heart, kidneys or brain. We tested the hypothesis that pre- or postconditioning with Sevoflurane attenuates pulmonary neutrophil accumulation after ischaemia/reperfusion injury of the aorta.

Methods

Anaesthetized and mechanically ventilated Wistar rats underwent laparotomy and were randomly assigned to one of the following groups: Sham (n = 10), ischaemia/reperfusion (n = 8, lower body ischaemia by clamping of the infrarenal aorta for 2 h followed by 3 h of reperfusion), preconditioning (n = 10, 2.0% Sevoflurane administered over 30 min prior to ischaemia) and postconditioning (n = 9, 2.0% Sevoflurane during reperfusion). Following reperfusion, the lungs were removed for microscopic determination of neutrophil accumulation.

Results

Ischaemia/reperfusion induced a significant increase in pulmonary neutrophil accumulation (mean ± SD, 29.9 ± 7.4 vs. 15.8 ± 6.6 neutrophils per microscopic field in ischaemia/reperfusion vs. Sham, respectively, P < 0.001). Sevoflurane preconditioning resulted in a lower neutrophil count (20.3 ± 7.1 neutrophils, P < 0.001 vs. ischaemia/reperfusion), while postconditioning showed no effects (25.8 ± 9.8 neutrophils vs. ischaemia/reperfusion, not significant).

Conclusions

Preconditioning, but not postconditioning, with Sevoflurane reduces pulmonary neutrophil accumulation after ischaemia/reperfusion injury of the lower body. Since neutrophil accumulation plays a major role in the pathophysiology of acute lung injury, our data suggest a protective effect of Sevoflurane preconditioning on remote pulmonary ischaemia/reperfusion injury.

Keywords

ANAESTHESIA INHALATIONSEVOFLURANELEUCOCYTESNEUTROPHILSLUNG FUNCTIONISCHAEMIA REPERFUSION
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 6 , June 2008 , pp. 454 - 459
Copyright
Copyright © European Society of Anaesthesiology 2008

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References

1.Adembri, C, Kastamoniti, E, Bertolozzi, L et al. Pulmonary injury follows systemic inflammatory reaction in infrarenal aortic surgery. Crit Care Med 2004; 32: 1170–1177.Google Scholar
2.Pararajasingam, R, Weight, SC, Bell, PR, Nicholson, ML, Sayers, RD. Pulmonary nitric oxide metabolism following infrarenal aortic cross-clamp-induced ischaemia-reperfusion injury. Eur J Vasc Endovasc Surg 2000; 19: 47–51.Google Scholar
3.Sookhai, S, Wang, JJ, McCourt, M, Kirwan, W, Bouchier-Hayes, D, Redmond, P. A novel therapeutic strategy for attenuating neutrophil-mediated lung injury in vivo. Ann Surg 2002; 235: 285–291.Google Scholar
4.Tassiopoulos, AK, Hakim, TS, Finck, CM et al. Neutrophil sequestration in the lung following acute aortic occlusion starts during ischaemia and can be attenuated by tumour necrosis factor and nitric oxide blockade. Eur J Vasc Endovasc Surg 1998; 16: 36–42.CrossRefGoogle ScholarPubMed
5.Lee, WL, Downey, GP. Neutrophil activation and acute lung injury. Curr Opin Crit Care 2001; 7: 1–7.CrossRefGoogle ScholarPubMed
6.Reutershan, J, Ley, K. Bench-to-bedside review: acute respiratory distress syndrome – how neutrophils migrate into the lung. Crit Care 2004; 8: 453–461.Google Scholar
7.Moraes, TJ, Zurawska, JH, Downey, GP. Neutrophil granule contents in the pathogenesis of lung injury. Curr Opin Hematol 2006; 13: 21–27.Google Scholar
8.Ng, CS, Wan, S, Arifi, AA, Yim, AP. Inflammatory response to pulmonary ischemia-reperfusion injury. Surg Today 2006; 36: 205–214.CrossRefGoogle ScholarPubMed
9.Fantini, GA, Conte, MS. Pulmonary failure following lower torso ischemia: clinical evidence for a remote effect of reperfusion injury. Am Surg 1995; 61: 316–319.Google ScholarPubMed
10.Gelman, S. The pathophysiology of aortic cross-clamping and unclamping. Anesthesiology 1995; 82: 1026–1060.CrossRefGoogle ScholarPubMed
11.Paterson, IS, Klausner, JM, Pugatch, R et al. Noncardiogenic pulmonary edema after abdominal aortic aneurysm surgery. Ann Surg 1989; 209: 231–236.CrossRefGoogle ScholarPubMed
12.Obal, D, Preckel, B, Scharbatke, H et al. One MAC of sevoflurane provides protection against reperfusion injury in the rat heart in vivo. Br J Anaesth 2001; 87: 905–911.Google Scholar
13.Obal, D, Scharbatke, H, Barthel, H, Preckel, B, Müllenheim, J, Schlack, W. Cardioprotection against reperfusion injury is maximal with only two minutes of sevoflurane administration in rats. Can J Anaesth 2003; 50: 940–945.Google Scholar
14.Obal, D, Dettwiler, S, Favoccia, C, Scharbatke, H, Preckel, B, Schlack, W. The influence of mitochondrial KATP-channels in the cardioprotection of preconditioning and postconditioning by sevoflurane in the rat in vivo. Anesth Analg 2005; 101: 1252–1260.Google Scholar
15.Varadarajan, SG, An, J, Novalija, E, Stowe, DF. Sevoflurane before or after ischemia improves contractile and metabolic function while reducing myoplasmic Ca(2+) loading in intact hearts. Anesthesiology 2002; 96: 125–133.CrossRefGoogle ScholarPubMed
16.Lee, HT, Ota-Setlik, A, Fu, Y, Nasr, SH, Emala, CW. Differential protective effects of volatile anesthetics against renal ischemia-reperfusion injury in vivo. Anesthesiology 2004; 101: 1313–1324.CrossRefGoogle ScholarPubMed
17.Obal, D, Rascher, K, Favoccia, C, Dettwiler, S, Schlack, W. Post-conditioning by a short administration of desflurane reduced renal reperfusion injury after differing of ischaemia times in rats. Br J Anaesth 2006; 97: 783–791.Google Scholar
18.Payne, RS, Akca, O, Roewer, N, Schurr, A, Kehl, F. Sevoflurane-induced preconditioning protects against cerebral ischemic neuronal damage in rats. Brain Res 2005; 1034: 147–152.Google Scholar
19.Zheng, S, Zuo, Z. Isoflurane preconditioning induces neuroprotection against ischemia via activation of P38 mitogen-activated protein kinases. Mol Pharmacol 2004; 65: 1172–1180.Google Scholar
20.Doerschuk, CM, Mizgerd, JP, Kubo, H, Qin, L, Kumasaka, T. Adhesion molecules and cellular biomechanical changes in acute lung injury: Giles F. Filley Lecture. Chest 1999; 116: 37S–43S.Google Scholar
21.Joyce, M, Kelly, CJ, Chen, G, Bouchier-Hayes, DJ. Pravastatin attenuates lower torso ischaemia-reperfusion-induced lung injury by upregulating constitutive endothelial nitric oxide synthase. Eur J Vasc Endovasc Surg 2001; 21: 295–300.Google Scholar
22.Walder, B, Fontao, E, Totsch, M, Morel, DR. Time and tidal volume-dependent ventilator-induced lung injury in healthy rats. Eur J Anaesthesiol 2005; 22: 785–794.Google Scholar
23.Murry, CE, Jennings, RB, Reimer, KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation 1986; 74: 1124–1136.Google Scholar
24.De Hert, SG, Turani, F, Mathur, S, Stowe, DF. Cardioprotection with volatile anesthetics: mechanisms and clinical implications. Anesth Analg 2005; 100: 1584–1593.Google Scholar
25.Bouwman, RA, Salic, K, Padding, FG et al. Cardioprotection via activation of protein kinase C-delta depends on modulation of the reverse mode of the Na+/Ca2+ exchanger. Circulation 2006; 114: I226–I232.Google Scholar
26.Weber, NC, Stursberg, J, Wirthle, NM, Toma, O, Schlack, W, Preckel, B. Xenon preconditioning differently regulates p44/42 MAPK (ERK 1/2) and p46/54 MAPK (JNK 1/2 and 3) in vivo. Br J Anaesth 2006; 97: 298–306.Google Scholar
27.Mobert, J, Zahler, S, Becker, BF, Conzen, PF. Inhibition of neutrophil activation by volatile anesthetics decreases adhesion to cultured human endothelial cells. Anesthesiology 1999; 90: 1372–1381.Google Scholar
28.Reutershan, J, Chang, D, Hayes, JK, Ley, K. Protective effects of isoflurane pretreatment in endotoxin-induced lung injury. Anesthesiology 2006; 104: 511–517.Google Scholar
29.Liu, R, Ishibe, Y, Ueda, M, Hang, Y. Isoflurane administration before ischemia and during reperfusion attenuates ischemia/reperfusion-induced injury of isolated rabbit lungs. Anesth Analg 1999; 89: 561–565.Google Scholar
30.Liu, R, Ishibe, Y, Ueda, M. Isoflurane-sevoflurane administration before ischemia attenuates ischemia-reperfusion-induced injury in isolated rat lungs. Anesthesiology 2000; 92: 833–840.CrossRefGoogle ScholarPubMed