Complement Activation by Propofol and its Effect during Propofol Anaesthesia

Ohmizo, Hiroshi; Iwama, Hiroshi; Sugita, Toshihiro

doi:10.1177/0310057x9902700611

Cited by 10 publications

(7 citation statements)

References 19 publications

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“…A study by Ohmizo et al [12] shows that propofol mixed with blood in vitro results in elevated levels of C3a. The levels were elevated to the same extent when blood was mixed with the lipid solvent of propofol, which suggests that it is the lipid solvent and not propofol itself that activates complement [12]. In the present study, there was an activation of complement with elevated levels of the split product C3a.…”

Section: Discussionmentioning

confidence: 99%

Complement Activation and Interleukin Response in Major Abdominal Surgery

et al. 2012

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The objective of this study was to evaluate whether major abdominal surgery leads to complement activation and interleukin response and whether the kind of anaesthesia influence complement activation and the release of inflammatory interleukins. The study design was prospective and randomised. Fifty patients undergoing open major colorectal surgery due to cancer disease or inflammatory bowel disease were studied. Twenty‐five patients were given total intravenous anaesthesia (TIVA) with propofol and remifentanil, and 25 patients were given inhalational anaesthesia with sevoflurane and fentanyl. To determine complement activation (C3a and SC5b‐9) and the release of pro‐ and anti‐inflammatory interleukins (tumour necrosis factor‐a (TNF‐a)), interleukin‐1b (IL‐1b), IL‐6, IL‐8, IL‐4 and IL‐10), blood samples were drawn preoperatively, 60 minutes after start of surgery, 30 minutes after end of surgery and 24 hours postoperatively. Complement was activated and pro‐inflammatory interleukins (IL‐6 and IL‐8) and anti‐inflammatory interleukins (IL‐10) were released during major colorectal surgery. There was no significant difference between TIVA and inhalational anaesthesia regarding complement activation and cytokine release. Major colorectal surgery leads to activation of the complement cascade and the release of both pro‐inflammatory and anti‐inflammatory cytokines. There are no significant differences between total intravenous anaesthesia (TIVA) with propofol and remifentanil and inhalational anaesthesia with sevoflurane and fentanyl regarding complement activation and the release of pro‐ and anti‐inflammatory interleukins.

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Section: Discussionmentioning

confidence: 99%

Complement Activation and Interleukin Response in Major Abdominal Surgery

et al. 2012

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“…The intravenous induction agent propofol activates complement when mixed with plasma in vitro . However, during propofol anaesthesia, the accumulation of C3a is minimal [18]. Propofol was used in standard doses in both treatment groups in our study.…”

Section: Discussionmentioning

confidence: 99%

Alternative Pathway Activation of Complement in Laparoscopic and Open Rectal Surgery

et al. 2012

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The study was designed to investigate whether complement is activated in patients subject to rectal surgery and whether the choice of surgical technique (open or laparoscopic) has any impact on the activation of complement. Our hypothesis is that laparoscopic surgery leads to a lower‐level activation of complement than open surgery. Patients (n = 24) subject to rectal surgery owing to rectal cancer were included. The study was prospective and randomized. The patients were randomized to either laparoscopic surgery (n = 12) or open surgery (n = 12). Blood samples for determination of complement activation (C4d, Bb, C3bc and the terminal C5b‐9 complex TCC) were drawn before start of surgery (T0) and at the following time‐points after start of surgery: 180 min (T1), 360 min (T2), 24 h (T3) and 3–5 days (T4). A significant increase in the alternative pathway activation product Bb and in the terminal pathway activation product TCC was seen over time in both groups (P < 0.001). Bb peaked early (T1) and returned to baseline levels post‐operatively, whereas TCC increased steadily with maximum values in the late post‐operative period. The plasma concentrations of C4d and C3bc decreased significantly in both groups at T1 and T2 and returned to baseline levels at T4. There was no significant difference between the groups. Rectal surgery causes activation of the complement system. Complement is activated through the alternative pathway. Results mostly showed no significant differences between laparoscopic and open rectal surgery apart from lower levels of factor Bb in the former group in the perioperative period.

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“…With regard to the clinical situation, it should be considered, that patients with acute liver failure or multiorgan failure often represent a comparable kind of "blood pool" because of the often-necessary concomitant transfusion therapy. Additionally, these clinical conditions as well as the necessary use of sedative and analgesic drugs can induce a preactivation of the complement system independent of the application of an extracorporeal system (21).…”

Section: Discussionmentioning

confidence: 99%

Impact of Inverse Plasma Filtration on Complement Activation in Porcine Blood

2005

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During extracorporeal circulation, activation of the complement system as a bioincompatibility reaction upon contact with artificial surfaces is well known. This may induce adverse effects for the patient as well as for the bioreactor when using a hybrid liver support system. At present, the achievable clearance rates in hybrid liver support systems are restricted by the limitations of blood flow through the capillaries of the plasma filter. In order to enhance clearance rates it is desirable to develop a high-flow plasma separation unit in which the activation of the complement system is as low as possible. Conventional plasma filters operating in normal and in inverse (blood flow around the capillaries and the capillary lumen serving as plasma compartment) modes were investigated applying an in vitro circuit (n = 4 in each group). For this purpose heparinized porcine blood was used. Complement activation was measured as generation of the soluble membrane attack complex, SC5b-9. With a normal flow mode the maximum achievable filtration rates varied from 25 to 40 mL/min, whereas the maximal filtration rates with an inverse flow mode varied from 40 to 100 mL/min. While these values were significantly higher than those with regularly operating plasma filters, there was no significant difference between normal and inverse mode in the production of SC5b-9. We conclude that the outer surface of the investigated conventional plasma filtration membranes is suitable for an inverse mode and does not lead to an excessive activation of the complement system upon dynamic blood contact. Thus, the inversion of the blood and the plasma compartments may be a possible way forward in the development of a high-flow plasma separation filter.

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Complement Activation by Propofol and its Effect during Propofol Anaesthesia

Cited by 10 publications

References 19 publications

Complement Activation and Interleukin Response in Major Abdominal Surgery

Complement Activation and Interleukin Response in Major Abdominal Surgery

Alternative Pathway Activation of Complement in Laparoscopic and Open Rectal Surgery

Impact of Inverse Plasma Filtration on Complement Activation in Porcine Blood

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