Document Detail

Xenon and isoflurane improved biventricular function during right ventricular ischemia and reperfusion.
MedLine Citation:
PMID:  19839950     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although anesthetics have some cardioprotective properties, these benefits are often counterbalanced by their negative inotropic effects. Xenon, on the other hand, does not influence myocardial contractility. Thus, xenon may be a superior treatment for the maintenance of global hemodynamics, especially during right ventricular ischemia, which is generally characterized by a high acute complication rate. METHODS: The effects of 70 vol% xenon and 0.9 vol% isoflurane on biventricular function were assessed in a porcine model (n=36) using the conductance catheter technique, and the expression of the type B natriuretic peptide (BNP) gene was measured. The animals underwent 90 min of right ventricular ischemia followed by 120 min of reperfusion. A barbiturate-anesthetized group was included as a control. RESULTS: Cardiac output was compromised in unprotected animals during ischemia by 33+/-18% and during reperfusion by 53+/-17%. This was mainly due to impaired contractility in the left ventricle (LV) and increased stiffness. Isoflurane attenuated the increase in stiffness and resulted in a higher preload. In contrast, xenon increased the right ventricular afterload, which was compensated by an increase in contractility. Its effects on diastolic function were less pronounced. Upregulation of BNP mRNA expression was impeded in the remote area of the LV by both isoflurane and xenon. CONCLUSIONS: Xenon and isoflurane demonstrated equipotent effects in preventing the hemodynamic compromise that is induced by right ventricular ischemia and reperfusion, although they acted through somewhat differential inotropic and vasodilatory effects.
M Hein; A B Roehl; J H Baumert; C Bleilevens; S Fischer; P Steendijk; R Rossaint
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-15
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  470-8     Citation Subset:  IM    
Department of Anesthesiology, University Hospital of Aachen, Aachen, Germany.
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MeSH Terms
Anesthetics, Inhalation / therapeutic use*
Cardiac Output / drug effects,  physiology
Data Interpretation, Statistical
Isoflurane / pharmacology*
Myocardial Contraction / drug effects,  physiology
Myocardial Reperfusion Injury / physiopathology*,  prevention & control*
Natriuretic Peptide, Brain / blood,  genetics
RNA, Messenger / biosynthesis,  genetics
Reverse Transcriptase Polymerase Chain Reaction
Ventricular Dysfunction, Right / drug therapy*,  physiopathology
Ventricular Function, Left / physiology
Xenon / therapeutic use*
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/RNA, Messenger; 114471-18-0/Natriuretic Peptide, Brain; 26675-46-7/Isoflurane; 7440-63-3/Xenon

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