Document Detail

Isoflurane inhibits compensatory intravascular volume expansion after hemorrhage in sheep.
MedLine Citation:
PMID:  16861416     Owner:  NLM     Status:  MEDLINE    
After hemorrhage, blood volume is partially restored by transcapillary refill, a process of spontaneous compensatory intravascular volume expansion that we hypothesized would be inhibited by anesthesia. Six chronically instrumented sheep were subjected to four randomly ordered experiments while conscious or during anesthesia with isoflurane. After plasma volume measurement (indocyanine green), 15% or 45% of the blood volume was withdrawn. To quantify transcapillary refill, mass balance and kinetic calculations utilized repeated measurements of hemoglobin concentration, assuming that transcapillary refill would dilute hemoglobin concentration. After 15% hemorrhage, mean arterial blood pressure remained stable in both conscious and isoflurane-anesthetized sheep (normotensive hemorrhage) but decreased after 45% hemorrhage (hypotensive hemorrhage). After either normotensive or hypotensive hemorrhage, transcapillary refill occurred more rapidly during the first 40 min than during the next 140 min (P < 0.001). In conscious sheep, at 180 min, 57% and 42% of the bled volume had been restored after normotensive and hypotensive hemorrhage, respectively, in contrast to only 13% and 27% (P < 0.001) in isoflurane-anesthetized sheep. A novel kinetic model implicated hemodynamic factors in rapid, early transcapillary refill and decreased plasma oncotic pressure in subsequent slower filling. We conclude that isoflurane inhibits transcapillary refill after both normotensive and hypotensive hemorrhage in sheep.
Robert G Hahn; Lance Brauer; Peter Rodhe; Christer H Svensén; Donald S Prough
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  103     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-24     Completed Date:  2006-08-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  350-8, table of contents     Citation Subset:  AIM; IM    
Department of Anesthesiology, Karolinska Institute at Soder Hospital, 118 83 Stockholm, Sweden.
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MeSH Terms
Anesthetics, Inhalation / pharmacology*
Blood Volume / drug effects*,  physiology
Capillary Permeability
Hemorrhage / physiopathology*
Hydrostatic Pressure
Isoflurane / pharmacology*
Osmotic Pressure
Reg. No./Substance:
0/Anesthetics, Inhalation; 26675-46-7/Isoflurane

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

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