title: Volatile anesthetics improve survival after cecal ligation and puncture.
abstract: BACKGROUND
  Sepsis remains a leading cause of death in intensive care units. There is growing evidence that volatile anesthetics have beneficial immunomodulatory effects on complex inflammation-mediated conditions. The authors investigated the effect of volatile anesthetics on the overall survival of mice in a sepsis model of cecal ligation and puncture (CLP).
  
  
  METHODS
  Mice (N = 12 per treatment group) were exposed to anesthetic concentrations of desflurane, isoflurane, and sevoflurane either during induction of sepsis or when the mice showed pronounced symptoms of inflammation. Overall survival, as well as organ function and inflammation was compared with the CLP group without intervention.
  
  
  RESULTS
  With desflurane and sevoflurane conditioning (1.2 minimal alveolar concentration for 2 h immediately after induction of CLP) overall survival was improved to 58% and 83%, respectively, compared with 17% in the untreated CLP group. Isoflurane did not significantly affect outcome. Application of sevoflurane 24 h after sepsis induction significantly improved overall survival to 66%.
  
  
  CONCLUSIONS
  Administration of the volatile anesthetics desflurane and sevoflurane reduced CLP-induced mortality. Anesthesia may be a critical confounder when comparing study data where different anesthesia protocols were used.
authors.affiliation: * Research Associate, Institute of Anesthesiology, University Hospital Zurich and Institute of Physiology and Zurich Centre for Integrative Human Physiology, University of Zurich, Zurich, Switzerland. † Research Assistant, Department of Anesthesiology, University of Illinois College of Medicine at Chicago, Chicago, Illinois, and Department of Pharmacology, University of Illinois at Chicago, Chicago, Illinois. ‡ Full Professor, Department of Anesthesiology, University of Illinois College of Medicine at Chicago. § Technician, Institute of Anesthesiology, University Hospital Zurich and Institute of Physiology and Zurich Centre for Integrative Human Physiology, University of Zurich. ‖Research Associate, Institute of Anesthesiology, University Hospital Zurich and Institute of Physiology and Zurich Centre for Integrative Human Physiology, University of Zurich. # Associate Professor, Department of Anesthesiology, University of Illinois College of Medicine at Chicago, and Department of Pharmacology, University of Illinois at Chicago. ** Associate Professor, Department of Anesthesiology, University of Illinois College of Medicine at Chicago, and Department of Pharmacology, University of Illinois at Chicago. †† Full Professor, Institute of Anesthesiology, University Hospital Zurich and Institute of Physiology and Zurich Centre for Integrative Human Physiology, University of Zurich.
authors.forename: Inge K
authors.initials: IK
authors.lastname: Herrmann
authors.forename: Maricela
authors.initials: M
authors.lastname: Castellon
authors.forename: David E
authors.initials: DE
authors.lastname: Schwartz
authors.forename: Melanie
authors.initials: M
authors.lastname: Hasler
authors.forename: Martin
authors.initials: M
authors.lastname: Urner
authors.forename: Guochang
authors.initials: G
authors.lastname: Hu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Minshall
authors.forename: Beatrice
authors.initials: B
authors.lastname: Beck-Schimmer
mesh_terms: D018685:Anesthetics, Inhalation / Q000378:metabolism / Q000494:pharmacology*; D000818:Animals; D002432:Cecum / Q000293:injuries*; D000077335:Desflurane; D004195:Disease Models, Animal; D007249:Inflammation / Q000150:complications / Q000378:metabolism; D007530:Isoflurane / Q000031:analogs & derivatives / Q000378:metabolism / Q000494:pharmacology; D008026:Ligation; D008297:Male; D008738:Methyl Ethers / Q000378:metabolism / Q000494:pharmacology; D051379:Mice; D008810:Mice, Inbred C57BL; D018805:Sepsis / Q000150:complications / Q000378:metabolism / Q000401:mortality*; D000077149:Sevoflurane; D014951:Wounds, Stab
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane