Document Detail


Preconditioning with monophosphoryl lipid A improves survival of critically ischemic tissue.
MedLine Citation:
PMID:  15920214     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In this study we sought to assess the effects of preconditioning with monophosphoryl lipid A on critically ischemic wound margins and on systemic and local hemodynamics and oxygenation during prolonged anesthesia with volatile anesthetics and narcotics. Twenty large white pigs were randomly assigned to receive either monophosphoryl lipid A 35 mug/kg IV or saline 24 h before dissection of a buttock flap. The animals were anesthetized with isoflurane (end-tidal concentration approximately 1.25%) for surgery and subsequent monitoring of hemodynamics and oxygenation both systemically and in the flap tissue for 6 h. Preconditioning resulted in increased cardiac index and oxygen delivery (both P < 0.05) and in decreased central venous pressure and systemic vascular resistance (both P < 0.01). In the preconditioned flap tissue, microcirculatory blood flow (laser Doppler flowmetry) and partial tissue oxygen tension (polarographic microprobes) were up to 2.5-fold higher compared with control (both P < 0.05) and flap necrosis was reduced by 20% on postoperative day 14 (P < 0.05). Our results suggest that preconditioning with a single dose of monophosphoryl lipid A may attenuate ischemia-related wound healing complications, which may be related to an improvement in perfusion and oxygenation of this tissue. Furthermore, preconditioning exerted a systemic cardiovascular stabilization effect during prolonged isoflurane anesthesia.
Authors:
Yves Harder; Claudio Contaldo; Joachim Klenk; Andrej Banic; Stephan M Jakob; Dominique Erni
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  100     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-05-27     Completed Date:  2005-06-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1786-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Plastic Surgery Inselspital University Hospital CH-3010 Berne, Switzerland. yvesharder@bluewin.cz
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, General
Animals
Blood Gas Analysis
Hemodynamics
Ischemic Preconditioning, Myocardial*
Laser-Doppler Flowmetry
Lipid A / analogs & derivatives*,  therapeutic use*
Myocardial Ischemia / drug therapy*,  pathology*
Myocardium / pathology
Surgical Flaps
Swine
Chemical
Reg. No./Substance:
0/Lipid A; 0/monophosphoryl lipid A

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


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