Document Detail

Inhibition of autonomic storm by epidural anesthesia does not influence cardiac inflammatory response after brain death in rats.
MedLine Citation:
PMID:  22974957     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: After brain death (BD) donors usually experience cardiac dysfunction, which is responsible for a considerable number of unused organs. Causes of this cardiac dysfunction are not fully understood. Some authors argue that autonomic storm with severe hemodynamic instability leads to inflammatory activation and myocardial dysfunction.
OBJECTIVES: To investigate the hypothesis that thoracic epidural anesthesia blocks autonomic storm and improves graft condition by reducing the inflammatory response.
METHODS: Twenty-eight male Wistar rats (250-350 g) allocated to four groups received saline or bupivacaine via an epidural catheter at various times in relation to brain-death induction. Brain death was induced by a sudden increase in intracranial pressure by rapid inflation of a ballon catheter in the extradural space. Blood gases, electrolytes, and lactate analyses were performed at time zero, and 3 and 6 hours. Blood leukocytes were counted at 0 and 6 hours. After 6 hours of BD, we performed euthanasia to measure vascular adhesion molecule (VCAM)-1, intracellular adhesion molecule (ICAM)-1, interleukin (IL)-1β, tumor necrosis factor (TNF)-α, Bcl-2 and caspase-3 on cardiac tissue.
RESULTS: Thoracic epidural anesthesia was effective to block the autonomic storm with a significant difference in mean arterial pressure between the untreated (saline) and the bupivacaine group before BD (P < .05). However, no significant difference was observed for the expressions of VCAM-1, ICAM-1, TNF-α, IL-1β, Bcl-2, and caspase-3 (P > .05).
CONCLUSION: Autonomic storm did not seem to be responsible for the inflammatory changes associated with BD; thoracic epidural anesthesia did not modify the expression of inflammatory mediators although it effectively blocked the autonomic storm.
I A Silva; C J Correia; R Simas; C D J Correia; J W M C Cruz; S G Ferreira; F L Zanoni; L Menegat; P Sannomiya; L F P Moreira
Related Documents :
24970557 - Development of a high-performance anesthesia ventilator for research in small animals.
16470077 - Prevalence, awareness, treatment, and control of hypertension: united states national h...
12214257 - A randomised controlled trial of the effect of anticipation of a blood test on blood pr...
24564317 - Effect of body position on intra-abdominal pressures and abdominal perfusion pressures ...
20682157 - Assessing the impact of lung hyperinflation maneuver on systemic inflammatory response ...
15875127 - Laryngeal mask airway can be inserted with inhaled desflurane induction.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transplantation proceedings     Volume:  44     ISSN:  1873-2623     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-14     Completed Date:  2013-01-31     Revised Date:  2013-02-03    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2213-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Laboratory of Cardiovascular Surgery, Heart Institute (InCor) of Sao Paulo University Medical School, Sao Paulo, Brazil.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Anesthesia, Epidural*
Autonomic Nervous System / physiopathology*
Brain Death*
Myocarditis / physiopathology*
Rats, Wistar
Erratum In:
Transplant Proc. 2012 Nov;44(9):2893
Note: Correia, C D J [removed]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Prognostic utility of hypothermic machine perfusion in deceased donor renal transplantation.
Next Document:  Extremely marginal liver grafts from deceased donors have outcome similar to ideal grafts.