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    
Abstract/OtherAbstract:
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.
Authors:
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
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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.
Affiliation:
Laboratory of Cardiovascular Surgery, Heart Institute (InCor) of Sao Paulo University Medical School, Sao Paulo, Brazil. isaacazevedo@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Epidural*
Animals
Autonomic Nervous System / physiopathology*
Brain Death*
Male
Myocarditis / physiopathology*
Rats
Rats, Wistar
Comments/Corrections
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


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