title: Opposing effects of isoflurane and sevoflurane on neurogenic pulmonary edema development in an animal model.
abstract: BACKGROUND
  The current study was undertaken to investigate the effects of pretreatment with isoflurane and sevoflurane on the development of neurogenic pulmonary edema in an animal model.
  
  
  METHODS
  Rats were exposed to room air (control), 1.5% isoflurane, or 2.5% sevoflurane for 4 h. They were then anesthetized with intraperitoneal injections of pentobarbital sodium, and fibrinogen and thrombin were injected into the cisterna magna to induce neurogenic pulmonary edema.
  
  
  RESULTS
  Consecutive injections of fibrinogen and thrombin caused increases in blood pressure, with the peak values obtained in the isoflurane and sevoflurane groups being lower than the control values. The incidence of significant neurogenic pulmonary edema was 58%, 100%, and 8% in the control, isoflurane, and sevoflurane groups, respectively. The lung water ratio, an index of severity of edema, was 4.86 +/- 0.78, 6.15 +/- 0.64, and 4.40 +/- 0.32 in the control, isoflurane, and sevoflurane groups, respectively. Furthermore, immunohistochemical staining for vascular endothelial growth factor demonstrated an increase of expression in the rat lungs exposed to isoflurane. Treatment with an anti-vascular endothelial growth factor antibody during exposure to isoflurane completely inhibited the effect of isoflurane to promote neurogenic pulmonary edema in this model.
  
  
  CONCLUSIONS
  Exposure to 1.5% isoflurane enhances the development of neurogenic pulmonary edema development in this animal model, most likely via release of vascular endothelial growth factor from bronchial epithelial cells, an effect not observed with sevoflurane.
authors.affiliation: Aichi Medical University, Nagakute-cho, Aichi-gun, Aichi Prefecture, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Kandatsu
authors.forename: Yong-Shan
authors.initials: YS
authors.lastname: Nan
authors.forename: Guo-Gang
authors.initials: GG
authors.lastname: Feng
authors.forename: Kimitoshi
authors.initials: K
authors.lastname: Nishiwaki
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Hirokawa
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Toru
authors.initials: T
authors.lastname: Komatsu
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokochi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimada
authors.forename: Naohisa
authors.initials: N
authors.lastname: Ishikawa
mesh_terms: D000818:Animals; D002478:Cells, Cultured; D004195:Disease Models, Animal; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism; D007530:Isoflurane / Q000008:administration & dosage / Q000633:toxicity*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D011654:Pulmonary Edema / Q000139:chemically induced* / Q000209:etiology* / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D000077149:Sevoflurane
chemical_list: D008738:Methyl Ethers; D000077149:Sevoflurane; D007530:Isoflurane