Effects of sevoflurane on hypoxic pulmonary vasoconstriction in anaesthetized piglets

Kerbaul, François; Bellezza, M.; Guidon, C.; Roussel, L.; Imbert, Michel; Carpentier, J.-P.; Auffray, Jean-Pierre

doi:10.1093/bja/85.3.440

Cited by 32 publications

(17 citation statements)

References 23 publications

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“…This technique has already been used in mammals to test the effects of anesthetics 5 and of physiologic or metabolic manipulations on HPV. 16,17 The P/Q plots in our piglets were linear in all experimental conditions, in keeping with previous studies in intact anaesthetized 5,6 or unsedated animals. 12 HPV shows a large inter-individual and inter-species variability.…”

Section: Desflurane In Hypoxiasupporting

confidence: 89%

“…11 Pulmonary hemodynamics were evaluated by multipoint pulmonary vascular pressures -flow plots (P/Q plots) which provide a quantitative characterization of the pulmonary vascular pressure (P)-cardiac output (Q) relationship. 6,7 Previous experiments have demonstrated that these plots are linear in intact anesthetized piglets. 12 M Ma at te er ri ia al l a an nd d m me et th ho od ds s All experimental procedures were reviewed and approved by the Animal Ethics Committee of La Timone Medical School in Marseille.…”

Section: [La Vasoconstriction Pulmonaire Hypoxique N'est Pas Inhibée mentioning

confidence: 94%

“…3,4 However halogenated agents seem to be less effective pulmonary vasodilators in in vivo lung lobes. [5][6][7] Desflurane is a recently introduced inhalational anesthetic. Its effects on HPV have been the focus of a few studies.…”

Section: [La Vasoconstriction Pulmonaire Hypoxique N'est Pas Inhibée mentioning

confidence: 99%

“…3,4,8 Conversely, experiments with intact mammals showed either an inhibition 23 or no significant effect. 6,9,24 Associated iv anesthetics This experiment required general anesthesia and mechanical ventilation. These anesthetic conditions resemble the clinical situation, where desflurane is administered with fentanyl.…”

Section: Desflurane In Hypoxiamentioning

confidence: 99%

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Sub-MAC concentrations of desflurane do not inhibit hypoxic pulmonary vasoconstriction in anesthetized piglets

et al. 2001

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P Pu ur rp po os se e: : In vitro, halogenated agents reduce the pulmonary vasoconstrictor response to alveolar hypoxia in isolated perfused lungs. However, studies in intact animals have been less convincing. The aim of the present study was to assess the effect of sub-MAC concentrations of desflurane on hypoxic pulmonary vasoconstriction (HPV) in anesthetized piglets using the pressure/cardiac output relationship (P/Q).M Me et th ho od ds s: : Eleven large white piglets were anesthetized and ventilated mechanically, alternatively in hyperoxia (FIO 2 =0.4) and in hypoxia (FIO 2 =0.12). Multipoint plots of pulmonary arterial pressure (PAP), or differences between PAP and left atrial pressure (LAP) against Q were generated by gradual inflation of a balloon advanced into the inferior vena cava. P/Q relationships were established in hyperoxia and in hypoxia at baseline, and then with gradual concentrations of desflurane.R Re es su ul lt ts s: : In hypoxia, pressure gradients (PAP-LAP) increased significantly at every level of Q, demonstrating active pulmonary vasoconstriction. Desflurane did not affect these P/Q relationships either in hyperoxia, or in hypoxia, when compared with baseline.C Co on nc cl lu us si io on n: : Desflurane at a clinically relevant dose has no significant effect on HPV in anesthetized piglets.Objectif: La plupart des agents halogénés dont le desflurane inhibent la vasoconstriction pulmonaire hypoxique (VPH) sur le poumon isolé de mammifère. Le but de cette étude est d évaluer les effets de cet halogéné sur la VPH du porc entier anesthésié, au moyen de la relation pression vasculaire trans-pulmonaire (PAP-POG)/débit cardiaque (Q). Résultats: En hypoxie, la pente des relations pression/débit a augmenté de façon significative, et ce pour chaque variation de Q mettant ainsi en évidence un phénomène de VPH active. Le desflurane n a pas eu d effet significatif sur les relations (PAP-POG)/Q en hyperoxie, ni en hypoxie. Matériel et méthodes: Conclusion:Contrairement aux études in vitro, le desflurane n inhibe pas, de façon significative la VPH du porc entier anesthésié.

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Section: Desflurane In Hypoxiasupporting

confidence: 89%

Section: [La Vasoconstriction Pulmonaire Hypoxique N'est Pas Inhibée mentioning

confidence: 94%

Section: [La Vasoconstriction Pulmonaire Hypoxique N'est Pas Inhibée mentioning

confidence: 99%

Section: Desflurane In Hypoxiamentioning

confidence: 99%

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Sub-MAC concentrations of desflurane do not inhibit hypoxic pulmonary vasoconstriction in anesthetized piglets

et al. 2001

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“…However, it has a number of limitations including systemic hypotension, changes in blood gases and changes in zonal conditions of the lung. This technique has already been used in mammals to test anaesthetic effects [12,13] and physiological or metabolic manipulations on HPV [7,14].…”

Section: Discussionmentioning

confidence: 99%

The effect of hypertonic saline dextran solutions on hypoxic pulmonary vasoconstriction in anaesthetised piglets

Bellezza¹,

Kerbaul²,

Roussel³

et al. 2002

Eur Respir J

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The effect of hypertonic saline dextran solutions on hypoxic pulmonary vasoconstriction in anaesthetised piglets. M. Bellezza, F. Kerbaul, L. Roussel, M. Imbert, C. Guidon. #ERS Journals Ltd 2002. ABSTRACT: Hypoxic pulmonary vasoconstriction (HPV) is a regulatory mechanism by which blood is diverted from poorly ventilated to better ventilated areas of the lung. The aim of the present study was to assess the extent to which hypertonic saline dextran and dextran solutions modify the magnitude of HPV during isovolumic haemodilution in intact acutely instrumented piglets.Eighteen large white piglets were anesthetised and assigned to two groups. Mean pulmonary arterial pressure (PAP) and cardiac output (Q), systemic arterial pressure and left arterial pressure (LAP) were measured. A decrease in Q was obtained by reducing venous return. This enabled measurement of transpulmonary pressures (mean PAP minus LAP) at four levels of Q in hyperoxia (inspiratory oxygen fraction (Fi,O 2 )=0.4), then in hypoxia (Fi,O 2= 0.1) in the two groups before blood soustraction (10 mL?kg -1 ) and after loading with sodium chloride (NaCl) 7.5% and dextran 6% or with dextran 6% alone. Dextran alone led to a decrease in mean PAP-LAP/Q values, and NaCl with dextran was associated with a significant shift of mean PAP-LAP/Q plots to higher pressures in hypoxia.Hypertonic saline dextran solution, as replacement fluid in isovolaemic haemodilution increased the magnitude of hypoxic pulmonary vasoconstriction, whereas dextran solution reduced it. Fluid expanders are usually used for the resuscitation of intraoperative hypovolaemia or haemorragia. They act on different parts of the cardiovascular system, mainly the heart and vascular resistances. Therefore, the vascular resistance response differs with the solution used and the vascular bed of the organ studied [1,2].Hypertonic saline solution (sodium chloride (NaCl) 7.5%) with dextran 6% has been shown to increase volaemia ten-times more than dextran 6% by an osmotic effect (transfer of water from the interstitial to vascular space), this, in turn, increases cardiac output (Q) and decreases systemic vascular resistance [3,4]. However, the effect of this hypertonic saline and dextran solution on pulmonary circulation remains unknown. Dextran used alone can also reduce pulmonary vascular resistance (PVR) resulting in a reduction of blood viscosity.Therefore, the effect of these two different plasma expanders on pulmonary vascular circulation was studied, focusing on the hypoxic pulmonary vascular response using pressure (P)/Q relationships in intact anaesthetised piglets submitted to normovolaemic haemodilution. It was hypothesised that these two different plasma expanders would have different effects on hypoxic pulmonary vasoconstriction (HPV), and thereby modify gas exchange. Piglets were chosen because they exhibit the greatest pulmonary vasoconstriction response to hypoxia [5]. In this study, pulmonary haemodynamics were evaluated by multipoint P/Q (mean pulmonary arterial pressure (PAP)-LAP/Q) ...

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Physiology, Pathophysiology, and Anesthetic Management of Patients with Respiratory Disease

McDonell

Kerr

2015

Veterinary Anesthesia and Analgesia

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Effects of sevoflurane on hypoxic pulmonary vasoconstriction in anaesthetized piglets

Cited by 32 publications

References 23 publications

Sub-MAC concentrations of desflurane do not inhibit hypoxic pulmonary vasoconstriction in anesthetized piglets

Sub-MAC concentrations of desflurane do not inhibit hypoxic pulmonary vasoconstriction in anesthetized piglets

The effect of hypertonic saline dextran solutions on hypoxic pulmonary vasoconstriction in anaesthetised piglets

Physiology, Pathophysiology, and Anesthetic Management of Patients with Respiratory Disease

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