Detecting alveolar epithelial injury following volatile anesthetics by (99m)Tc DTPA radioaerosol inhalation lung scan.
BACKGROUND
Many volatile anesthetics have long been thought to affect alveolar epithelial permeability.


OBJECTIVE
The purpose of this study was to examine the acute effects of volatile anesthetics on the permeability of the alveolocapillary barrier to (99m)Tc DTPA.


METHODS
Twenty-seven patients (24 females, 3 males, age 29-73 years) undergoing operation were enrolled in this study and grouped according to the type of anesthesia received. Group 1 patients were administered 1% halothane. Group 2 patients were given 1.5% isoflurane. Intravenous anesthesia without volatile anesthetics were used for group 3 patients. Before and after anesthesia, (99m)Tc DTPA radioaerosol inhalation lung scans were performed to detect alveolar epithelial injury due to volatile anesthetics. The negative slope of the regression line was designated as the (99m)Tc DTPA pulmonary clearance rate and was expressed in terms of percentage decrease in radioactivity per minute.


RESULTS
In group 1, the (99m)Tc DTPA clearance rates were 1.26 +/- 0.34 and 1.29 +/- 0.38 before and after anesthesia, respectively. The difference was not significant (p > 0.05). In group 2, the rates were 0.76 +/- 0.20 and 1.10 +/- 0. 37, before and after anesthesia, respectively. The difference was significant (p < 0.05). In group 3, the clearance rates were 1.07 +/- 0.38 and 1.21 +/- 0.48, before and after anesthesia, respectively. The difference was not significant.


CONCLUSIONS
Following isoflurane administration, the more rapid pulmonary clearance of (99m)Tc DTPA indicates that isoflurane increases the permeability of the alveolo-capillary barrier.
ChangLai
S P
SP
Department of Nuclear Medicine, Chung-Shan Medical and Dental College, Taichung, Taiwan, Republic of China.
Hung
W T
WT
Liao
K K
KK
D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000009:adverse effects* / Q000379:methods; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects*; D018686:Anesthetics, Intravenous; D004848:Epithelium / Q000000981:diagnostic imaging / Q000187:drug effects / Q000293:injuries; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006221:Halothane / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000293:injuries*; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D016284:Technetium Tc 99m Pentetate; D014055:Tomography, Emission-Computed
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D007530:Isoflurane; D005283:Fentanyl; D006221:Halothane; D016284:Technetium Tc 99m Pentetate