title: Sevoflurane preconditions stunned myocardium in septic but not healthy isolated rat hearts.
abstract: BACKGROUND
  Recent evidence indicates that sevoflurane treatment before prolonged ischaemia reduces infarct size in normal hearts, mimicking ischaemic preconditioning. We examined whether exposure to sevoflurane before brief ischaemia, inducing a 'stunned myocardium', provided such protective effects in an isolated working heart from normal or septic rats.
  
  
  METHODS
  With institutional approval, 91 rats were randomly allocated into one of either caecal-ligation and perforation (CLP: n=50) or sham (Sham: n=41) procedure groups 24 h before the study. After determination of baseline measurements, including cardiac output (CO), myocardial oxygen consumption (mVO(2)) and cardiac efficiency (CE; CO x peak systolic pressure/mVO(2)), each isolated heart was perfused with or without 2% sevoflurane for 15 min before global ischaemia (pre-ischaemia). After 15 min ischaemia and 30 min reperfusion, all hearts were assessed for functional recovery of myocardium (post-reperfusion).
  
  
  RESULTS
  During the pre-ischaemia period, 2% sevoflurane caused a significant reduction of CO in the CLP group compared with the Sham group. During the post-reperfusion period, both CO (16.9 vs 11.0 ml min(-1)) and CE (11.2 vs 7.7 mm Hg ml(-1) ( micro l O(2))(-1)) was higher in the sevoflurane-treated vs -untreated hearts from CLP rats, and was accompanied by lower incidence of reperfusion arrhythmia compared with control hearts (8 vs 32%). In contrast, 2% sevoflurane did not provide cardioprotective effects in normal rats.
  
  
  CONCLUSIONS
  The current study demonstrates that pre-treatment with sevoflurane minimizes myocardial dysfunction and the incidence of reperfusion arrhythmia after brief ischaemic insults in septic hearts.
authors.affiliation: Department of Anaesthesiology and General Intensive Care Unit, Keio University School of Medicine, Tokyo 160-8582, Japan. anesmrsk@sc.itc.keio.ac.jp
authors.forename: R
authors.initials: R
authors.lastname: Serita
authors.forename: H
authors.initials: H
authors.lastname: Morisaki
authors.forename: K
authors.initials: K
authors.lastname: Ai
authors.forename: Y
authors.initials: Y
authors.lastname: Morita
authors.forename: Y
authors.initials: Y
authors.lastname: Innami
authors.forename: T
authors.initials: T
authors.lastname: Satoh
authors.forename: S
authors.initials: S
authors.lastname: Kosugi
authors.forename: Y
authors.initials: Y
authors.lastname: Kotake
authors.forename: J
authors.initials: J
authors.lastname: Takeda
mesh_terms: D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D002302:Cardiac Output; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D019157:Ischemic Preconditioning, Myocardial; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology; D017682:Myocardial Stunning / Q000503:physiopathology*; D010101:Oxygen Consumption; D010710:Phosphates / Q000032:analysis; D051381:Rats; D017208:Rats, Wistar; D018805:Sepsis / Q000503:physiopathology*; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D010710:Phosphates; D000077149:Sevoflurane