title: Preconditioning, but not postconditioning, with Sevoflurane reduces pulmonary neutrophil accumulation after lower body ischaemia/reperfusion injury in rats.
abstract: OBJECTIVE
  Aortic ischaemia and reperfusion may induce pulmonary sequestration of neutrophil granulocytes. Preconditioning and postconditioning with volatile anaesthetics confer protection against reperfusion injury in various organs, such as heart, kidneys or brain. We tested the hypothesis that pre- or postconditioning with Sevoflurane attenuates pulmonary neutrophil accumulation after ischaemia/reperfusion injury of the aorta.
  
  
  METHODS
  Anaesthetized and mechanically ventilated Wistar rats underwent laparotomy and were randomly assigned to one of the following groups: Sham (n = 10), ischaemia/reperfusion (n = 8, lower body ischaemia by clamping of the infrarenal aorta for 2 h followed by 3 h of reperfusion), preconditioning (n = 10, 2.0% Sevoflurane administered over 30 min prior to ischaemia) and postconditioning (n = 9, 2.0% Sevoflurane during reperfusion). Following reperfusion, the lungs were removed for microscopic determination of neutrophil accumulation.
  
  
  RESULTS
  Ischaemia/reperfusion induced a significant increase in pulmonary neutrophil accumulation (mean +/- SD, 29.9 +/- 7.4 vs. 15.8 +/- 6.6 neutrophils per microscopic field in ischaemia/reperfusion vs. Sham, respectively, P < 0.001). Sevoflurane preconditioning resulted in a lower neutrophil count (20.3 +/- 7.1 neutrophils, P < 0.001 vs. ischaemia/reperfusion), while postconditioning showed no effects (25.8 +/- 9.8 neutrophils vs. ischaemia/reperfusion, not significant).
  
  
  CONCLUSIONS
  Preconditioning, but not postconditioning, with Sevoflurane reduces pulmonary neutrophil accumulation after ischaemia/reperfusion injury of the lower body. Since neutrophil accumulation plays a major role in the pathophysiology of acute lung injury, our data suggest a protective effect of Sevoflurane preconditioning on remote pulmonary ischaemia/reperfusion injury.
authors.affiliation: Heinrich-Heine-University Düsseldorf, Department of Anaesthesiology, Düsseldorf, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Kalb
authors.forename: P
authors.initials: P
authors.lastname: Schober
authors.forename: L A
authors.initials: LA
authors.lastname: Schwarte
authors.forename: J
authors.initials: J
authors.lastname: Weimann
authors.forename: S A
authors.initials: SA
authors.lastname: Loer
mesh_terms: D018685:Anesthetics, Inhalation; D000818:Animals; D001011:Aorta; D002465:Cell Movement / Q000187:drug effects / Q000502:physiology; D003250:Constriction; D019194:Ischemic Preconditioning / Q000379:methods*; D007813:Laparotomy; D008168:Lung; D008297:Male; D008738:Methyl Ethers; D009504:Neutrophils / Q000187:drug effects* / Q000502:physiology; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000503:physiopathology*; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane