Influence of sepsis on minimum alveolar concentration of desflurane in a porcine model.
The effect of sepsis on the minimum alveolar concentration of desflurane (MAC(DES)) in humans and other animals has not been reported previously. The aim of this study was to test the hypothesis that sepsis might alter MAC(DES) in a normotensive septic porcine model. Twenty-four young healthy pigs were premedicated with ketamine 10 mg kg(-1 )i.m and then anaesthesia was established with propofol 3 mg kg(-1) and the trachea was intubated. Baseline MAC(DES) in each pig was evaluated by pinching with a haemostat applied for 1 min to a rear dewclaw. MAC(DES) was determined by changing desflurane concentrations stepwise until purposeful movement appeared. Pigs were randomly assigned to two groups of 12 animals: the saline group received a 1 h i.v. infusion of saline solution while the sepsis group received a 1 h i.v. infusion of live Pseudomonas aeruginosa. Epinephrine and hydroxyethylstarch were used to maintain normotensive and normovolaemic haemodynamic status. In both groups, MAC(DES) was evaluated 5 h after infusion. Significant increases in heart rate, cardiac output, mean pulmonary artery pressure and pulmonary vascular resistance occurred in the sepsis group. MAC(DES) was 9.2% (95% confidence interval (CI) 6.8-10.6%) for the saline group and 6.7% (95% CI: 4.7-10.4) for the sepsis group (P<0.05). These data indicate that MAC(DES) is significantly decreased in this normotensive hyperkinetic septic porcine model.
Allaouchiche
B
B
Department of Anaesthesiology and Intensive Care, Hotel Dieu Hospital, Lyon, France.
Duflo
F
F
Debon
R
R
Tournadre
J P
JP
Chassard
D
D
D018685:Anesthetics, Inhalation / Q000493:pharmacokinetics*; D000818:Animals; D016470:Bacteremia / Q000378:metabolism* / Q000503:physiopathology; D000077335:Desflurane; D004195:Disease Models, Animal; D006439:Hemodynamics / Q000187:drug effects; D007530:Isoflurane / Q000031:analogs & derivatives / Q000493:pharmacokinetics*; D011650:Pulmonary Alveoli / Q000378:metabolism*; D013552:Swine
D018685:Anesthetics, Inhalation; D000077335:Desflurane; D007530:Isoflurane