The Influence of Endotoxemia on the Electroencephalographic and Antinociceptive Effects of Isoflurane in a Swine Model

Kurita, Tadayoshi; Takata, Kazuhide; Morita, Koji; Uraoka, Masahiro; Sato, Shigehito

doi:10.1213/ane.0b013e3181c22146

Cited by 11 publications

(8 citation statements)

References 24 publications

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“…Increased slowing was associated with poor outcomes, including delirium [54] and death [55]. In animal models, increased wake delta power [56], slowed EEG [57], and reduced theta frequencies have been described [26]. Slowed EEG may persist in former sepsis patients [19], but long term effects in animal models are less consistent [58-60].…”

Section: Discussionmentioning

confidence: 99%

Sepsis-Induced Brain State Instability

Kala

Leemburg

Ježek

2022

Preprint

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Background Sepsis-associated brain dysfunction (SABD) is a frequent severe complication of sepsis and the systemic inflammatory response syndrome. It is associated with high mortality and a majority of survivors suffer long-term neurological consequences. Sleep is commonly affected in sepsis and there is a strong correlation between its impairment and development of other complications or increased mortality in sepsis patients. Here, we investigate the effects of sepsis on brain activity patterns in order to better understand possible sources of sleep-wake disturbances associated with severe systemic inflammation. Methods We studied the effects of high LPS doses (10mg/kg) on oscillatory brain states in an acute rat model of sepsis under urethane anaesthesia, which maintains REM- and NREM sleep-like states. Twelve Long-Evans rats (6 LPS, 6 controls) were implanted with eight independently movable tetrodes in the dorsal hippocampus. Baseline LFP activity was recorded for 3 hours after saline injection, followed by another 3 hours after LPS or saline injection. REM and NREM were automatically classified based on LFP activity and quantified. Within- and between-state dynamics were analysed using a 2-D state space approach based on spectral power ratios. Aperiodic and periodic components of the power spectrum were quantified for each state. Blood serum samples and brains were collected for IL-1β quantification and histological verification of electrode placement. Results Soon after LPS injection we observed a robust fragmentation of both oscillatory states resulting in a three-fold increase in the number of state transitions that lasted for several hours, although the overall time spent in either state did not change. Analysis of power spectra showed opposing shifts in low frequency oscillations (1–9 Hz) in REM and NREM that resulted in increased similarity between both states in 2-D state space. Conclusions The observed increased spectral similarity between REM and NREM and increased instability within the states may point to a mechanism underlying the severe sleep fragmentation described both in sepsis patients and in SABD animal models.

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Section: Discussionmentioning

confidence: 99%

Sepsis-Induced Brain State Instability

Kala

Leemburg

Ježek

2022

Preprint

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“…Increased slowing was associated with poor outcomes, including delirium (Urdanibia-Centelles et al, 2021) and death (Yamanashi et al, 2021). In animal models, increased wake delta power (Kafa et al, 2010), slowed EEG (Kurita et al, 2010), and reduced theta frequencies have been described (Mamad et al, 2018). Slowed EEG may persist in former sepsis patients (Semmler et al, 2007), but long term effects in animal models are less consistent (Rong Gao et al, 2017; Ji et al, 2020; Wang et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Sepsis-induced brain state instability

Kala

Leemburg

Jezek

2022

Preprint

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Sepsis-associated brain dysfunction (SABD) is a frequent severe complication of sepsis and the systemic inflammatory response syndrome. It is associated with high mortality and a majority of survivors suffer long-term neurological consequences. Here, we studied the effects of SABD on oscillatory brain states in an acute rat model of sepsis induced by high dose LPS (10 mg/kg). To focus on intrinsically generated brain state dynamics, we used a urethane model that spares oscillatory activity in REM- and NREM-like sleep states. Soon after the intraperitoneal LPS injection we observed a robust fragmentation of both oscillatory states resulting in a three-fold increase in the number of state transitions that lasted for several hours, although the overall time spent in either state did not change. Analysis of power spectra showed opposing shifts in low frequency oscillations (1-9 Hz) that resulted in increased similarity between both states in 2-D state space. The described spectral characteristics of sepsis-induced EEG state instability might point to a mechanism underlying severe sleep fragmentation as described both in sepsis patients and in SABD animal models.

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“…10,15 The intraoperative use of opioids as part of a balanced anesthetic protocol reduces the requirement for volatile anesthetics. 11 However, opioids cause a dose-dependent, vagally mediated bradycardia that is counterbalanced by a baroreceptormediated increase in systemic blood pressure.…”

Section: Discussionmentioning

confidence: 99%

“…3,[5][6][7][8][9][10] Dogs with septic peritonitis may require anesthesia for diagnostic procedures or surgery, and they are generally poor anesthesia candidates because their hemodynamic stability is often compromised.…”

Section: Effect Of Intraoperative Constant Rate Infusion Of Lidocainementioning

confidence: 99%

Effect of intraoperative constant rate infusion of lidocaine on short-term survival of dogs with septic peritonitis: 75 cases (2007–2011)

Bellini¹,

Seymour²

2016

javma

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The full details of the published version of the article are as follows: Small Animals S eptic peritonitis is associated with a high mortality rate, and it is a major cause of sepsis in dogs. The most common predisposing cause for septic peritonitis is the contamination of (or translocation into) the peritoneal cavity by microorganisms normally present in abdominal organs. 1,2 Endotoxins produced by bacteria cause the release of inflammatory cytokines, including interleukin, tumor necrosis factor, and prostanoids, which contribute to vasomotor paralysis and capillary occlusion with secondary leakage of fluid into the interstitium. [3][4][5][6][7] The clinical signs of septic peritonitis may be vague, but distributive shock fre- OBJECTIVETo investigate whether intraoperative administration of a lidocaine infusion to dogs with septic peritonitis was associated with short-term (48 hours) survival after surgery. DESIGN Retrospective case series.ANIMALS 75 dogs with septic peritonitis. PROCEDURESMedical records of dogs with septic peritonitis that underwent laparotomy between January 2007 and December 2011 at the Royal Veterinary College were reviewed. Select variables during the preoperative, intraoperative, and postoperative periods and short-term survival after surgery were compared between dogs that received an opioid only (group O; n = 33) and dogs that received lidocaine (50 µg/kg/min [22.7 µg/kg/min], IV; group L; 42) in addition to an opioid during surgery. RESULTSThe proportion of dogs that survived for 48 hours after surgery was significantly greater for group L (35/42) than for group O (20/33). Intraoperative infusion of lidocaine increased the odds of short-term survival (OR, 8.77; 95% CI, 1.94 to 39.57). No significant differences were observed between the 2 treatment groups for variables assessed during the preoperative and postoperative periods. During the intraoperative period, more dogs in group L received an IV bolus of a synthetic colloid than did dogs in group O, but the number of IV boluses administered was not associated with short-term survival. CONCLUSIONS AND CLINICAL RELEVANCEResults indicated that IV infusion of lidocaine might improve the short-term survival of dogs with septic peritonitis. Prospective clinical trials are necessary to determine the efficacy of lidocaine as a supportive treatment for dogs with septic peritonitis. (J Am Vet Med Assoc 2016;248:422-429)

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The Influence of Endotoxemia on the Electroencephalographic and Antinociceptive Effects of Isoflurane in a Swine Model

Abstract: Endotoxemia increases both the hypnotic and antinociceptive effects of isoflurane, in contrast to hemorrhagic shock, and the extent of these alterations increases with progression of endotoxemia.

Cited by 11 publications

References 24 publications

Sepsis-Induced Brain State Instability

Sepsis-Induced Brain State Instability

Sepsis-induced brain state instability

Effect of intraoperative constant rate infusion of lidocaine on short-term survival of dogs with septic peritonitis: 75 cases (2007–2011)

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