Loss of Alveolar Macrophages During Anesthesia and Operation in Humans

• Published in: Anesthesia and analgesia Vol. 81; no. 6; pp. 1255 - 1262
• Main Authors: Kotani, Naoki, Lin, Chung-Yuan, Wang, Jian-Sheng, Gurley, Judith M, Tolin, Fredrik P, Michelassi, Fabrizio, Lin, Hsiu-San, Sandberg, Warren S, Roizen, Michael F
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01.12.1995; Lippincott
• Subjects: Adolescent; Adult; Aged; Anesthesia; Anesthesia, Inhalation - adverse effects; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Inhalation - administration & dosage; Anesthetics, Inhalation - adverse effects; Biological and medical sciences; Bronchoalveolar Lavage Fluid - cytology; Cell Aggregation - drug effects; Cell Count; Cell Survival - drug effects; Coloring Agents; Female; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; Humans; Inflammatory Bowel Diseases - surgery; Isoflurane - administration & dosage; Isoflurane - adverse effects; Macrophages, Alveolar - drug effects; Macrophages, Alveolar - pathology; Macrophages, Alveolar - physiology; Male; Medical sciences; Middle Aged; Nitrous Oxide - administration & dosage; Nitrous Oxide - adverse effects; Postoperative Complications; Time Factors; Trypan Blue; Human; Immune response; Pulmonary alveolus; Surgery; Lung; General anesthesia; Complication; Cellular immunity; Macrophage
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1097/00000539-199512000-00023

Pulmonary macrophages play an important role in the host defense against infection, and the importance of this role is probably enhanced when the upper airway defenses are circumvented by endotracheal intubation.Studies in animals suggest that exposure to volatile anesthetics compromises the viability and function of alveolar macrophages. We studied the effect of surgery and anesthesia on the alveolar macrophages of 41 human subjects undergoing lower abdominal procedures of varying lengths during nitrous oxide-isoflurane anesthesia. Alveolar macrophages were harvested from bronchoalveolar lavage fluid obtained before incision and compared to those recovered just before emergence from anesthesia. Macrophages were analyzed for aggregation and viability, assessed by the ability of viable cells to exclude trypan blue dye. Operations lasting 2 h or less led to little aggregation and had little effect on viability. However, there was a strong correlation between loss of macrophages and the duration of surgery and anesthesia. Aggregation increased and viability decreased as a function of procedure length. Studies are needed to determine whether prolonged surgery contributes to the incidence of postoperative pulmonary complications by disturbing the function and survival of alveolar macrophages in humans.(Anesth Analg 1995;81:1255-62)