Faculty Opinions recommendation of Late pharmacologic conditioning with volatile anesthetics after cardiac surgery.

2012 ◽  
Author(s):  
Michael Haney
Keyword(s):  
Cardiac Surgery ◽  
Volatile Anesthetics

scholarly journals Late pharmacologic conditioning with volatile anesthetics after cardiac surgery

Critical Care ◽  
2012 ◽  
Vol 16 (5) ◽  
pp. R191 ◽  
Author(s):  
Marc P Steurer ◽  
Martina A Steurer ◽  
Werner Baulig ◽  
Tobias Piegeler ◽  
Martin Schläpfer ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Volatile Anesthetics

scholarly journals The Anesthesia in Abdominal Aortic Surgery (ABSENT) Study

2013 ◽  
Vol 119 (4) ◽  
pp. 802-812 ◽  
Author(s):  
Espen E. Lindholm ◽  
Erlend Aune ◽  
Camilla B. Norén ◽  
Ingebjørg Seljeflot ◽  
Thomas Hayes ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Complications ◽  
Aortic Surgery ◽  
Volatile Anesthetics ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic ◽  
Anesthesia Group ◽  
Coronary Events

Abstract Background: On the basis of data indicating that volatile anesthetics induce cardioprotection in cardiac surgery, current guidelines recommend volatile anesthetics for maintenance of general anesthesia during noncardiac surgery in hemodynamic stable patients at risk for perioperative myocardial ischemia. The aim of the current study was to compare increased troponin T (TnT) values in patients receiving sevoflurane-based anesthesia or total intravenous anesthesia in elective abdominal aortic surgery. Methods: A prospective, randomized, open, parallel-group trial comparing sevoflurane-based anesthesia (group S) and total intravenous anesthesia (group T) with regard to cardioprotection in 193 patients scheduled for elective abdominal aortic surgery. Increased TnT level on the first postoperative day was the primary endpoint. Secondary endpoints were postoperative complications, nonfatal coronary events and mortality. Results: On the first postoperative day increased TnT values (>13 ng/l) were found in 43 (44%) patients in group S versus 41 (43%) in group T (P = 0.999), with no significant differences in TnT levels between the groups at any time point. Although underpowered, the authors found no differences in postoperative complications, nonfatal coronary events or mortality between the groups. Conclusions: In elective abdominal aortic surgery sevoflurane-based anesthesia did not reduce myocardial injury, evaluated by TnT release, compared with total intravenous anesthesia. These data indicate that potential cardioprotective effects of volatile anesthetics found in cardiac surgery are less obvious in major vascular surgery.

scholarly journals Volatile anesthetics in cardiac surgery: Renoprotective, cardioprotective, neither, or both?

2014 ◽  
Vol 148 (6) ◽  
pp. 3137-3138
Author(s):  
Nicholas D. Andersen
Keyword(s):  
Cardiac Surgery ◽  
Volatile Anesthetics

scholarly journals Anesthetics to Prevent Lung Injury in Cardiac Surgery (APLICS): A protocol for a randomized, controlled trial

2018 ◽  
Author(s):  
Brian P. O’Gara ◽  
Balachundhar Subramaniam ◽  
Shahzad Shaefi ◽  
Ariel Mueller ◽  
Valerie Banner-Goodspeed ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Lung Injury ◽  
Ischemia Reperfusion ◽  
Controlled Trial ◽  
Volatile Anesthetics ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complications ◽  
Randomized Controlled

Abstract Background Patients undergoing cardiac surgery with cardiopulmonary bypass are at an increased risk of developing postoperative pulmonary complications, potentially leading to excess morbidity and mortality. It is likely that pulmonary ischemia-reperfusion (IR) injury during cardiopulmonary bypass is a major contributor to perioperative lung injury. Therefore, interventions that can minimize IR injury would be valuable in reducing the excess burden of this potentially preventable disease process. Volatile anesthetics including sevoflurane have been shown in both preclinical and human trials to effectively limit pulmonary inflammation in a number of settings including ischemia-reperfusion injury. However, this finding has not yet been demonstrated in the cardiac surgery population. The Anesthetics to Prevent Lung Injury in Cardiac Surgery (APLICS) trial is a randomized, controlled trial investigating whether sevoflurane anesthetic maintenance can modulate pulmonary inflammation occurring during cardiac surgery with cardiopulmonary bypass, and whether this potential effect can translate to a reduction in postoperative pulmonary complications. Methods APLICS is a prospective, randomized controlled trial of adult cardiac surgical patients. Subjects will be randomized to receive intraoperative anesthetic maintenance with either sevoflurane or propofol. Patients in both groups will be ventilated according to protocols intended to minimize the influences of ventilator induced lung injury and hyperoxia. Bronchoalveolar lavage (BAL) and blood sampling will take place after anesthetic induction and between two to four hours after pulmonary reperfusion. The primary outcome is a difference between groups in the incidence of inflammatory lung injury, defined by an increase in post-bypass BAL concentrations of TNFα. Secondary outcomes will include additional relevant BAL and systemic inflammatory markers and the incidence of postoperative pulmonary complications. Discussion APLICS investigates whether anesthetic choice can influence lung inflammation and pulmonary outcomes following cardiac surgery with cardiopulmonary bypass. A positive result from this trial would add to the growing body of evidence describing the lung protective properties of the volatile anesthetics and potentially reduce unnecessary morbidity for cardiac surgery patients. Trial Registration ClinicalTrials.gov identifier NCT02918877, registered on September 29, 2016. KEYWORDS Inflammatory lung injury, volatile anesthetics, cardiac surgery, postoperative pulmonary complications, TNFα.

scholarly journals Volatile anesthetics in cardiac surgery: the impalpable benefit

Vessel Plus ◽  
2018 ◽  
Vol 2018 ◽  
Author(s):  
Annalaura Di Pumpo ◽  
Chiara Candela ◽  
Fabrizio Cucciniello ◽  
Domenico Sarubbi ◽  
Felice Eugenio Agrò
Keyword(s):  
Cardiac Surgery ◽  
Volatile Anesthetics

Cardioprotection with Volatile Anesthetics in Cardiac Surgery

2008 ◽  
Vol 16 (3) ◽  
pp. 256-264 ◽  
Author(s):  
Suraphong Lorsomradee ◽  
Stefanie Cromheecke ◽  
Sratwadee Lorsomradee ◽  
Stefan G De Hert
Keyword(s):  
Cardiac Surgery ◽  
Volatile Anesthetics
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