Volatile Anesthetics Improve Survival after Cecal Ligation and Puncture

• Published in: Anesthesiology (Philadelphia) Vol. 119; no. 4; pp. 901 - 906
• Main Authors: HERRMANN, Inge K, CASTELLON, Maricela, SCHWARTZ, David E, HASLER, Melanie, URNER, Martin, GUOCHANG HU, MINSHALL, Richard D, BECK-SCHIMMER, Beatrice
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.10.2013
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Inhalation - metabolism; Anesthetics, Inhalation - pharmacology; Animals; Biological and medical sciences; Cecum - injuries; Disease Models, Animal; Inflammation - complications; Inflammation - metabolism; Isoflurane - analogs & derivatives; Isoflurane - metabolism; Isoflurane - pharmacology; Ligation; Male; Medical sciences; Methyl Ethers - metabolism; Methyl Ethers - pharmacology; Mice; Mice, Inbred C57BL; Sepsis - complications; Sepsis - metabolism; Sepsis - mortality; Wounds, Stab; Anesthesia; Improvement; Ligature; Puncture; Anesthetic; Survival
• ISSN: 0003-3022; 1528-1175
• DOI: 10.1097/aln.0b013e3182a2a38c

Sepsis remains a leading cause of death in intensive care units. There is growing evidence that volatile anesthetics have beneficial immunomodulatory effects on complex inflammation-mediated conditions. The authors investigated the effect of volatile anesthetics on the overall survival of mice in a sepsis model of cecal ligation and puncture (CLP). Mice (N = 12 per treatment group) were exposed to anesthetic concentrations of desflurane, isoflurane, and sevoflurane either during induction of sepsis or when the mice showed pronounced symptoms of inflammation. Overall survival, as well as organ function and inflammation was compared with the CLP group without intervention. With desflurane and sevoflurane conditioning (1.2 minimal alveolar concentration for 2 h immediately after induction of CLP) overall survival was improved to 58% and 83%, respectively, compared with 17% in the untreated CLP group. Isoflurane did not significantly affect outcome. Application of sevoflurane 24 h after sepsis induction significantly improved overall survival to 66%. Administration of the volatile anesthetics desflurane and sevoflurane reduced CLP-induced mortality. Anesthesia may be a critical confounder when comparing study data where different anesthesia protocols were used.