title: The mechanisms of cardio-protective effects of desflurane and sevoflurane at the time of reperfusion: anaesthetic post-conditioning potentially translatable to humans?
abstract: Myocardial conditioning is actually an essential strategy in the management of ischaemia-reperfusion injury. The concept of anaesthetic post-conditioning is intriguing, its action occurring at a pivotal moment (that of reperfusion when ischaemia reperfusion lesions are initiated) where the activation of these cardio-protective mechanisms could overpower the mechanisms leading to ischaemia reperfusion injuries. Desflurane and sevoflurane are volatile anaesthetics frequently used during cardiac surgery. This review focuses on the efficacy of desflurane and sevoflurane administered during early reperfusion as a potential cardio-protective strategy. In the context of experimental studies in animal models and in human atrial tissues in vitro, the mechanisms underlying the cardio-protective effect of these agents and their capacity to induce post-conditioning have been reviewed in detail, underlining the role of reactive oxygen species generation, the activation of the cellular signalling pathways, and the actions on mitochondria along with the translatable actions in humans; this might well be sufficient to set the basis for launching randomized clinical studies, actually needed to confirm this strategy as one of real impact.
authors.affiliation: Department of Anaesthesiology and Intensive Care, France and Faculty of Medicine, Centre Hospitalier Universitaire de Caen, Normandie Université, Pôle d'Anesthésie-Réanimation Chirurgicale - Niveau 6, CHU de Caen, Avenue Cote de Nacre, Caen Cedex 14033, France sand.lemoine2@wanadoo.fr.
authors.forename: S
authors.initials: S
authors.lastname: Lemoine
authors.affiliation: Department of Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Tritapepe
authors.affiliation: Department of Anaesthesiology and Intensive Care, France and Faculty of Medicine, Centre Hospitalier Universitaire de Caen, Normandie Université, Pôle d'Anesthésie-Réanimation Chirurgicale - Niveau 6, CHU de Caen, Avenue Cote de Nacre, Caen Cedex 14033, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Hanouz
authors.affiliation: Department of Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: P E
authors.initials: PE
authors.lastname: Puddu
mesh_terms: D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000818:Animals; D002316:Cardiotonic Agents / Q000494:pharmacology*; D000077335:Desflurane; D006801:Humans; D057775:Ischemic Postconditioning; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology; D008738:Methyl Ethers / Q000494:pharmacology*; D009203:Myocardial Infarction / Q000517:prevention & control; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D002316:Cardiotonic Agents; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane
keywords: desflurane; mechanisms; mitochondria; myocardial reperfusion injury/prevention; sevoflurane