Amino acid infusions started after development of intraoperative core hypothermia do not affect rewarming but reduce the incidence of postoperative shivering during major abdominal surgery: a randomized trial

Inoue, Satoki; Shinjo, Takeaki; Kawaguchi, Masahiko; Nakajima, Yoshiyuki; Furuya, Hitoshi

doi:10.1007/s00540-011-1230-4

Cited by 17 publications

(8 citation statements)

References 26 publications

(38 reference statements)

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“…Changes in the initial temperature drop and subsequent plateau phase, which represent the early phase of sepsis, were also observed in iNOS-KO mice. These changes resemble the three phases of development of core hypothermia during general anesthesia [34]: an initial decrease in temperature resulting from core-to-peripheral redistribution of body heat, then a slow and linear decrease caused by total body heat loss, and finally a temperature plateau accompanied by metabolic heat production and vasoconstriction. Given that sepsis is one of the most common pathologies of distributive shock, the temperature drop in the early phase may result from the redistribution of body heat induced by several vasodilator mediators.…”

Section: Discussionmentioning

confidence: 75%

Inducible nitric oxide synthase during the late phase of sepsis is associated with hypothermia and immune cell migration

Takatani

Ono

Suzuki

et al. 2018

Laboratory Investigation

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Hypothermia is a significant sign of sepsis, which is associated with poor prognosis, but few mechanisms underlying the regulation of hypothermia are known. Inducible nitric oxide synthase (iNOS) is a key inflammatory mediator of sepsis. However, the therapeutic benefit of iNOS inhibition in sepsis is still controversial, and requires elucidation in an accurate model system. In this study, wild-type (WT) mice showed temperature drops in a biphasic manner at the early and late phase of sepsis, and all mice died within 48 h of sepsis. In contrast, iNOS-knockout (KO) mice never showed the second temperature drop and exhibited improved mortality. Plasma nitric oxide (NO) levels of WT mice increased in the late phase of sepsis and correlated to hypothermia. The results indicate that iNOS-derived NO during the late phase of sepsis caused vasodilation-induced hypothermia and a lethal hypodynamic state. The expression of the iNOS mRNA was high in the lung of WT mice with sepsis, which reflects the pathology of acute respiratory distress syndrome (ARDS). We obtained the results in a modified keyhole-type cecal ligation and puncture model of septic shock induced by minimally invasive surgery. In this accurate and reproducible model system, we transplanted the bone marrow cells of GFP transgenic mice into WT and iNOS-KO mice, and evaluated the role of increased pulmonary iNOS expression in cell migration during the late phase of sepsis. We also investigated the quantity and type of bone marrow-derived cells (BMDCs) in the lung. The number of BMDCs in the lung of iNOS-KO mice was less than that in the lung of WT mice. The major BMDCs populations were CD11b-positive, iNOS-negative cells in WT mice, and Gr-1-positive cells in iNOS-KO mice that expressed iNOS. These results suggest that sustained hypothermia may be a beneficial guide for future iNOS-targeted therapy of sepsis, and that iNOS modulated the migratory efficiency and cell type of BMDCs in septic ARDS.

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Section: Discussionmentioning

confidence: 75%

Inducible nitric oxide synthase during the late phase of sepsis is associated with hypothermia and immune cell migration

Takatani

Ono

Suzuki

et al. 2018

Laboratory Investigation

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“…Intraoperative amino acid infusions enhanced thermogenic effects and prevented hypothermia effectively during general anesthesia [5]. However, amino acid infusions started after the This article is protected by copyright of Korean Journal of Anesthesiology.…”

Section: Multimodal Warming Measures -Letter To the Editor -mentioning

confidence: 99%

Perioperative management of a patient with severe cold agglutinin disease by using multimodal warming measures

Koyama

Asami

Nishikawa

et al. 2021

Korean J Anesthesiol

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“…Literatürdeki çalışmalarda aminoasit infüzyonunun hastanede kalış süresini kısalttığına dair çalışmalar yer almakla birlikte, [18][19][20] bir yarar sağlamadığını dile getiren çalışmalar da vardır ve kesin bir sonuca varılamamıştır. 21,22 Houge ve ark., 23 161 elektif cerrahi (vertebra, intraabdominal, torasik) olgusu üzerinde yaptıkları çalışmada, 75 µg kg-1dak-1 propofol infüzyonu ile remifentanil 0,5 µg kg-1dak-1 ve 1 µg kg-1dak-1 olarak iki farklı infüzyon hızında kullanmışlardır. 1 µg kg-1dak-1 dozundaki remifentanilin entübasyon sonrası oluşan hemodinamik yanıtları daha iyi baskıladığını göstermişlerdir.…”

Section: Gereç Ve Yöntemunclassified

The effects of intravenous aminoacid infusion on myocardial functions and postoperative analgesia during abdominal aortic surgery

Turhan¹

2013

Dicle Med J

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Objective: Effects of intravenous aminoacid infusion on myocardial functions and postoperative analgesia in abdominal aortic surgery were investigated. Materials and methods: Forty patients were randomly divided into groups of general anaesthesia with or without aminoacid infusion (Group 1 and 2, n=10), combined general+epidural with or without amino acid infusion (Group 3 and 4, n=10). Cardiac risk was evaluated using 2007 AHA/ ACC and modified Goldman classifications. Intravenous aminoacid solution of 80 g/L was infused at 2.5 ml/kg/h for a total of 8 hours. General anaesthesia included intravenous remifentanil, rocuronium, sevoflurane. The lumbar epidural include; 10 mL of 0.25% bupivacaine; bolus dose, an infusion of 0.25% bupivacaine; 4 ml/h for 24 hours. Heart rate, arterial blood pressures were collected intraoperative every 10 minute, 1, 24 hour postoperatively. Plasma creatine kinase MB fraction, troponin levels, pain assessment with numeric analog scale were collected preoperatively, 1, 24 hour postoperatively. Postoperative 24 hour analgesic usage, complications were recorded. Results: Patients with mild and severe cardiac risk were higher in 2007 AHA/ACC classification (26/40, 65%) than modified Goldman risk classification (5/40, 12.5%) (p=0.04). In comparison between groups, myocardial enzyme levels and complications showed no difference (p>0.05). The use of analgesics were lower in group 3 and 4 in comparison to group 1 and 2 (p=0.002). Conclusion: During abdominal aortic surgery, intravenous infusion of amino acid did not show significant changes on intraoperative and postoperative hemodynamic parameters and myocardial enzymes. The patients received combined general plus epidural anaesthesia showed more successful postoperative analgesia.

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Amino acid infusions started after development of intraoperative core hypothermia do not affect rewarming but reduce the incidence of postoperative shivering during major abdominal surgery: a randomized trial

Cited by 17 publications

References 26 publications

Inducible nitric oxide synthase during the late phase of sepsis is associated with hypothermia and immune cell migration

Inducible nitric oxide synthase during the late phase of sepsis is associated with hypothermia and immune cell migration

Perioperative management of a patient with severe cold agglutinin disease by using multimodal warming measures

The effects of intravenous aminoacid infusion on myocardial functions and postoperative analgesia during abdominal aortic surgery

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