Editorial II

Yamakage, Michiaki

doi:10.1093/bja/88.5.624

Cited by 8 publications

(2 citation statements)

References 27 publications

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“…Treatment with inhaled anesthetics generally results in improvement within 12 hours, although such agents have also been used for periods of several days in refractory cases [26-30]. The exact mechanism of action by which these agents relax airway smooth muscle is not completely understood [31], and their routine clinical use is hampered by predictable hemodynamic and sedative side effects [25]. These include myocardial depression, arrhythmias, intrapulmonary shunting, and cerebral vasodilation [32], all of which may limit the dose that can be administered or necessitate additional pharmacologic treatment.…”

Section: Bronchodilation With Volatile Anestheticsmentioning

confidence: 99%

Volatile anesthetics and the treatment of severe bronchospasm: a concept of targeted delivery

Mondoñedo

McNeil

Amin

et al. 2015

Drug Discovery Today: Disease Models

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Status asthmaticus (SA) is a severe, refractory form of asthma that can result in rapid respiratory deterioration and death. Treatment of SA with inhaled anesthetics is a potentially life-saving therapy, but remarkably few data are available about its mechanism of action or optimal administration. In this paper, we will review the clinical use of inhaled anesthetics for treatment of SA, the potential mechanisms by which they dilate constricted airways, and the side effects associated with their administration. We will also introduce the concept of ‘targeted’ delivery of these agents to the conducting airways, a process which may maximize their therapeutic effects while minimizing associated systemic side effects. Such a delivery regimen has the potential to define a rapidly translatable treatment paradigm for this life-threatening disorder.

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Section: Bronchodilation With Volatile Anestheticsmentioning

confidence: 99%

Volatile anesthetics and the treatment of severe bronchospasm: a concept of targeted delivery

Mondoñedo

McNeil

Amin

et al. 2015

Drug Discovery Today: Disease Models

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“…The dominant mechanism of bronchodilation for these agents are not completely understood [19]. Volatile anesthetics induce direct relaxation of airway smooth muscle (ASM) by reduction of intracellular free calcium via inhibition of protein kinase C, calcium release from sarcoplasmic reticulum, or voltage-dependent calcium channels [20–22].…”

Section: Introductionmentioning

confidence: 99%

Targeted Versus Continuous Delivery of Volatile Anesthetics During Cholinergic Bronchoconstriction

Mondoñedo

McNeil

Herrmann

et al. 2018

Journal of Engineering and Science in Medical Diagnostics and Therapy

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Volatile anesthetics have been shown to reduce lung resistance through dilation of constricted airways. In this study, we hypothesized that that diffusion of inhaled anesthetics from airway lumen to smooth muscle would yield significant bronchodilation in vivo, and systemic recirculation would not be necessary to reduce lung resistance (RL) and elastance (EL) during sustained bronchoconstriction. To test this hypothesis, we designed a delivery system for precise timing of inhaled volatile anesthetics during the course of a positive pressure breath. We compared changes in RL, EL, and anatomic dead space (VD) in canines (N=5) during pharmacologically-induced bronchoconstriction with intravenous methacholine, and following treatments with: 1) targeted anesthetic delivery to VD; and 2) continuous anesthetic delivery throughout inspiration. Both sevoflurane and isoflurane were used during each delivery regimen. Compared to continuous delivery, targeted delivery resulted in significantly lower doses of delivered anesthetic and decreased end-expiratory concentrations. However, we did not detect significant reductions in RL or EL for either anesthetic delivery regimen. This lack of response may have resulted from an insufficient dose of the anesthetic to cause bronchodilation, or from the preferential distribution of air flow with inhaled anesthetic delivery to less constricted, unobstructed regions of the lung, thereby enhancing airway heterogeneity and increasing apparent RL and EL.

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Measurement of Airway Hyperresponsiveness in Mice

Takeda¹

2022

Methods in Molecular Biology

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Editorial II

Cited by 8 publications

References 27 publications

Volatile anesthetics and the treatment of severe bronchospasm: a concept of targeted delivery

Volatile anesthetics and the treatment of severe bronchospasm: a concept of targeted delivery

Targeted Versus Continuous Delivery of Volatile Anesthetics During Cholinergic Bronchoconstriction

Measurement of Airway Hyperresponsiveness in Mice

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