부산대학교 도서관

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1399-6576.2008.01844.x Byline: J. J. HAITSMA (1,2,3), B. LACHMANN (3), P. J. PAPADAKOS (1) Abstract: Background: It has been suggested that propofol with ethylenediaminetetraacetic acid (EDTA) can modulate the systemic inflammatory response. Prolonged higher levels of pulmonary inflammation are associated with poor outcome of patients with acute lung injury. In the present study, we hypothesized that pulmonary inflammation could be modulated by propofol with EDTA compared with propofol with sulfite. Methods: Respiratory distress was induced in rats (n=25) by intratracheal nebulization of lipopolysaccharide (LPS). After 24 h, animals were randomized to either propofol with EDTA (Propofol.sub.EDTA), propofol with sulfite (Propofol.sub.sulfite) or ketamine/midazolam (Ket/Mid); control animals received saline (n=30). Animals were ventilated for 4 h and blood gases were measured hourly. Bronchoalveolar lavage (BAL) was performed for cytokine analysis of: tumor necrosis factor (TNF), interleukin (IL)-6 and macrophage inflammatory protein (MIP)-2. Results: LPS led to increased pulmonary inflammation in all groups compared with the control groups. Gas exchange deteriorated over time only in the LPS Propofol.sub.sulfite group and was significantly lower than the Ket/Mid group. Only IL-6 was significantly higher in the LPS Propofol.sub.sulfite group compared with both the Ket/Mid group and the Propofol.sub.EDTA group. Conclusion: Pulmonary IL-6 can be modulated by additives in systemic anesthesia. Implication Statement: This study demonstrates that pulmonary inflammation caused by direct lung injury can be modulated by intravenous anesthesia used in critically ill patients. Author Affiliation: (1)Departments of Anesthesiology, Surgery and Neurosurgery, University of Rochester, School of Medicine and Dentistry, Rochester, NY (2)Interdepartmental division of Critical Care Medicine, St Michael's Hospital, University of Toronto, Toronto, ON, Canada (3)Department of Anesthesiology, Erasmus-MC Faculty, Rotterdam, the Netherlands Article History: Accepted for publication 14 October 2008 Article note: Address:, Jack J. Haitsma, Interdepartmental division of Critical Care Medicine, University of Toronto, Keenan Research Center, Li Ka, Shing Knowledge Institute, St Michael's Hospital, 30 Bond Street, Queen Wing 4-042, Toronto, ON, Canada M5B 1W8, e-mail: jack.haitsma@utoronto.ca