title: Influence of propofol and volatile anaesthetics on the inflammatory response in the ventilated lung.
abstract: BACKGROUND
  The immunomodulatory effects of volatile anaesthetics in vitro and the protective effect of propofol in lung injury spurred us to study the effects of volatile anaesthetics and propofol on lung tissue in vivo.
  
  
  METHODS
  Twenty-seven pigs were randomized to 4-h general anaesthesia with propofol (8 mg/kg/h, group P, n=9), sevoflurane [minimum alveolar concentration (MAC)=1.0, group S, n=9) or desflurane (MAC=1.0, group D, n=9). Four healthy animals served as the no-ventilation group. Bronchoalveolar lavage fluid (BALF) was obtained to measure the cell counts, platelet-activating factor acetylhydrolase (PAF-AcH), phospholipase A(2) (PLA(2)) and superoxide dismutase (SOD) activity. Lung tissues were evaluated histologically and for caspase-3 expression.
  
  
  RESULTS
  Volatile anaesthetics reduced PAF-AcH levels without affecting PLA(2) activity and resulted in decreased alveolar macrophage and increased lymphocyte counts in BALF (sevoflurane: 29 ± 23%; desflurane: 26 ± 6%, both P<0.05 compared with 4 ± 2% in the no-ventilation group). These findings were accompanied by atelectasis and inflammatory cells' infiltration in the inhalational anaesthetics groups. Also, sevoflurane reduced SOD activity and both sevoflurane and desflurane induced significant caspase-3 expression. In contrast, propofol resulted in a minor degree of inflammation and preserved BALF cells' composition without triggering apoptosis.
  
  
  CONCLUSIONS
  Halogenated anaesthetics seem to trigger an immune lymphocytic response in the lung, inducing significant apoptosis and impairment of PAF-AcH. In contrast, propofol preserves anti-inflammatory and anti-oxidant defences during mechanical ventilation, thus preventing the emergence of apoptosis.
authors: 2nd Department of Anaesthesiology, Medical School, University of Athens, Attikon Hospital, Greece. k_kalimeris@hotmail.com
authors: K
authors: K
authors: Kalimeris
authors: K
authors: K
authors: Christodoulaki
authors: P
authors: P
authors: Karakitsos
authors: A
authors: A
authors: Batistatou
authors: M
authors: M
authors: Lekka
authors: M
authors: M
authors: Bai
authors: E
authors: E
authors: Kitsiouli
authors: G
authors: G
authors: Nakos
authors: G
authors: G
authors: Kostopanagiotou