Effects of general anesthesia on systemic inflammatory response during cardiac surgery with extracorporeal circulation
https://doi.org/10.17802/2306-1278-2019-8-4-145-152
Abstract
Systemic inflammatory response syndrome (SIRS) is a severe complication in surgical patients associated with increased morbidity and mortality. Anesthetics are known to produce certain effects on the immune system and the manifestation of SIRS. The understanding of these beneficial mechanisms allows selecting optimal anesthetics in order to reduce the manifestation of SIRS and infectious complications in the postoperative period.
About the Authors
R. R. Adzhigaliev
Federal State Budgetary Institution “Federal Center for Cardiovascular Surgery” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests: not
Russian Federation
Ruslan R. - anesthesiologist and intensivist at the Intensive Care Unit.
4, Pokrovskaya Roscha St., Astrakhan, 414011; phones +7 (8512) 478-518, +7 (960) 851-25-10
Competing Interests: not
A. E. Bautin
Federal State Budgetary Institution “Almazov National Medical Research Centre” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests: not
Russian Federation
Bautin Andrei E. - PhD, Head of the Intensive Care Research Laboratory, Associate Professor at the Department of Intensive Care.
2, Akkuratova St., St. Petersburg, 197341
Competing Interests: not
V. V. Pasyuga
Federal State Budgetary Institution “Federal Center for Cardiovascular Surgery” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Competing Interests: not
Russian Federation
Pasyuga Vadim V. - PhD, Head of the Intensive Care Unit
4, Pokrovskaya Roscha St., Astrakhan, 414011
Competing Interests: not
References
1. Kohl B.A., Deutschman C.S. The inflammatory response to surgery and trauma. Curr. Opin. Crit. Care. 2006; 12: 325-332.
2. Balk R.A. Pathogenesis and management of multiple organ dysfunction or failure in severe sepsis and septic shock. Crit. Care Clin. 2000; 16: 337-52. doi:10.1016/S0749-0704(05)70113-5.
3. Nesher N., Frolkis I., Vardi M., Sheinberg N., Bakir I., Caselman F. et al. Higher levels of serum cytokines and myocardial tissue markers during on-pump versus off-pump coronary artery bypass surgery. J. Card. Surg. 2006; 21: 395402. doi: 10.1111/j.1540-8191.2006.00272.x
4. Stassano P, Di Tommaso L., Monaco M., Iesu S., Brando G., Buonpane S., Ambrosio G., Di Benedetto G., Pepino P Myocardial revascularization by left ventricular assisted beating heart is associated with reduced systemic inflammatory response. Ann. Thorac. Surg. 2009; 87: 46-52. doi: 10.1016/j.athoracsur.2008.07.098.
5. Colucci D.G., Puig N.R., Hernandez PR. Influence of anesthetic drugs on immune response: from inflammation to immunosuppression. OA Anesthetics. 2013; 1: 21-38.
6. Kurosawa S., Kato M. Anesthetics, immune cells, and immune responses. J. Anesth. 2008; 22: 263-77. doi: 10.1007/s00540-008-0626-2.
7. Schneemilch C.E., Schilling T., Bank U. Effects of general anaesthesia on inflammation. Best Pract. Res. Clin. Anaesthesiol. 2004; 18: 493-507.
8. Lee Y.M., Song B.C., Yeum K.J..Impact of volatile anesthetics on oxidative stress and inflammation. Biomed Res Int. 2015;2015:242709. doi: 10.1155/2015/242709.
9. Loix S., De Kock M., Henin P The anti-inflammatory effects of ketamine: state of the art. Acta Anaesthesiol. Belg. 2011; 62: 47-58.
10. Kock M., Loix S., Lavand’homme P. Ketamine and peripheral inflammation. CNS Neurosci. Ther. 2013; 19: 40310. doi: 10.1111/cns.12104.
11. Welters I.D., Hafer G., Menzebach A., Muhling J, Neuhauser C, Browning P, Goumon Y.
12. Author informationet al. Ketamine inhibits transcription factors activator protein 1 and nuclear factor-kappab, Interleukin-8 production, as well as CD11b and CD16 expression: studies in human leukocytes and leukocytic cell lines. Anesth. Analg. 2010; 110: 934-41. doi: 10.1213/ANE.0b013e3181c95cfa.
13. Hirota K., Lambert D.G. Ketamine: new uses for an old drug? Br. J. Anaesth. 2011; 107: 123-6. doi: 10.1093/bja/aer221.
14. Heller A., Heller S., Blecken S., Urbaschek R., Koch T. Effects of intravenous anesthetics on bacterial elimination in human blood in vitro. Acta Anaesthesiol. Scand. 1998; 42: 518-26.
15. Roytblat L., Talmor D., Rachinsky M., Greemberg L., Pekar A., Appelbaum A., Gurman G.M., Shapira Y, Duvdenani A. Ketamine attenuates the interleukin-6 response after cardiopulmonary bypass. Anesth. Analg. 1998; 87: 266-71.
16. Memi§ D., Hekimoglu S., Vatan I., Yandim T., Yuksel M. Effects of midazolam and dexmedetomidine on inflammatory responses and gastric intramucosal pH to sepsis, in critically ill patients. Br. J. Anaesth. 2007; 98: 550-2. doi: 10.1093/bja/aem017
17. Zavala F., Haumont J., Lenfant M. Interaction of benzodiazepines with mouse macrophages. Eur. J. Pharmacol. 1984; 106: 561-6.
18. Kim S.N., Son S.C., Lee S.M., Kim C.S., Yoo D.G., Lee S.K., Hur G.M., Park J.B., Jeon B.H. Midazolam inhibits proinflammatory mediators in the lipopolysaccharide-activated macrophage. Anesthesiology. 2006; 105: 105-10. DOI: 10.1097/00000542-200607000-00019
19. Szekely A., Heindl B., Zahler S., Conzen P.F., Becker B. F. Nonuniform behavior of intravenous anesthetics on postischemic adhesion of neutrophils in the guinea pig heart. Anesth. Analg. 2000; 90: 1293-300.
20. Heine J., Leuwer M., Scheinichen D., Arseniev L., Jaeger K., Piepenbrock S. Flow cytometry evaluation of the in vitro influence of four i.v. anaesthetics on respiratory burst of neutrophils. Br. J. Anaesth. 1996; 77: 387-92.
21. Nishina K., Akamatsu H., Mikawa K., Shiga M., Maekawa N., Obara H., Niwa Y The inhibitory effects of thiopental, midazolam, and ketamine on human neutrophil functions. Anesth. Analg. 1998; 86: 159-65. doi: 10.1097/00000539-199801000-00032
22. Eberhardt K.E., Thimm B.M., Spring A., Maskos W.R. Dose-dependent rate of nosocomial pulmonary infection in mechanically ventilated patients with brain oedema receiving barbiturates: a prospective case study. Infection. 1992; 20: 12-8.
23. Corcoran T.B., Engel A., Sakamoto H., O’Callaghan-Enright S., O’Donnell A., Heffron J.A., et al. The effects of propofol on lipid peroxidation and inflammatory response in elective coronary artery bypass grafting. J. Cardiothorac. Vasc. Anesth. 2004; 18: 592-604. doi: 10.1053/j.jvca.2004.07.018
24. Petros A.J., Bogle R.G., Pearson J.D. Propofol stimulates nitric oxide release from cultured porcine aortic endothelial cells. Br. J. Pharmacol. 1993; 109: 6-7.
25. Mathy-Hartert M., Mouithys-Mickalad A., Kohnen S., Deby-Dupont G., Lamy M., Hans P. Effects of propofol on endothelial cells subjected to a peroxynitrite donor (SIN-1). Anaesthesia. 2000; 55: 1066-71.
26. Mikawa K., Akamatsu H., Nishina K., Shiga M., Maekawa N., Obara H. et al. Propofol inhibits human neutrophil functions. Anesth. Analg. 1998; 87: 695-700.
27. Christiansen C.L., Ahlburg P., Jakobsen C.J., Andresen E.B., Paulsen P.K. The influence of propofol and midazolam/ halothane anesthesia on hepatic SvO2 and gastric mucosal pH during cardiopulmonary bypass. J. Cardiothorac. Vasc. Anesth. 1998; 12: 418-21.
28. Gilliland H.E., Armstrong M. A., Carabine U., McMurray T.J. The choice of anesthetic maintenance technique influences the antiinflammatory cytokine response to abdominal surgery. Anesth. Analg. 1997; 85: 1394-8.
29. Galley H.F., Dubbels A.M., Webster N.R. The effect of midazolam and propofol on interleukin-8 from human polymorphonuclear leukocytes. Anesth. Analg. 1998; 86:1289-93.
30. Cleary T.G., Pickering L.K. Mechanisms of intralipid effect on polymorphonuclear leukocytes. J. Clin. Lab. Immunol. 1983; 11: 21-6.
31. Li B., Li Y., Tian S., Wang H., Wu H., Zhang A., Gao C. Anti-inflammatory effects of perioperative dexmedetomidine administered as an adjunct to general anesthesia: a metaanalysis. Sci. Rep. 2015; 5: 12342. doi: 10.1038/srep12342.
32. Louvier N., Lancon J.P. Do halogenated anesthetics protect from ischemic and reperfusion myocardial injuries? Ann. Fr. Anesth. Reanim. 1994; 13: 690-8.
33. Blum F.E., Zuo Z. Volatile anesthetics-induced neuroinflammatory and anti-inflammatory responses. Med. Gas. Res. 2013; 3: 16. doi: 10.1186/2045-9912-3-16
34. Sacerdote P. Opioids and the immune system. Palliat. Med. 2006; 20: 9-15.
35. Lysle D.T., Hoffman K.E., Dykstra L.A. Evidence for the involvement of the caudal region of the periaqueductal gray in a subset of morphine-induced alterations of immune status. J. Pharmacol. Exp. Therap. 1996; 277: 1533-40.
36. Al-Hashimi M., Scott W.M., Thompson J.P., Lambert D. G. Editor's choice: Opioids and immune modulation: more questions than answers. Br. J. Anaesth. 2013; 111: 80-8. doi: 10.1093/bja/aet153.
37. Stefano G.B., Rodriguez M., Glass R., Cesares F., Hughes T.K., Bilfinger T.V. Hyperstimulation of leukocytes by plasma from cardiopulmonary bypass patients is diminished by morphine and IL-10 pretreatment. J. Cardiovasc. Surg. 1995; 36 (1): 25-30.
38. Stefano G.B., Scharrer B., Smith E.M., Hughes T.K. Jr., Magazine H.I., Bilfinger T.V., Hartman A.R., Fricchione G.L., Liu Y., Makman M.H. Opioid and opiate immunoregulatory processes. Crit. Rev. Immunol. 1996; 16 (2): 109-144. doi: 10.1615/critrevimmunol.v16.i2.10
39. Murphy G.S., Szokol J.W., Marymont J.H., Avram M.J., Vender J.S. The effects of morphine and fentanyl on the inflammatory response to cardiopulmonary bypass in patients undergoing elective coronary artery bypass graft surgery. Anesth. Analg. 2007; 104 (6): 1334-1342. doi: 10.1213/01.ane.0000264108.47280.f5
40. Claxton A.R., McGuire G., Chung F., Cruise C. Evaluation of morphine versus fentanyl for postoperative analgesia after ambulatory surgical procedures. Anesth. Analg. 1997; 84 (3): 509-514.
41. Murphy G.S., Szokol J.W., Marymont J.H., Greenberg S.B., Avram M.J., Vender J.S., Sherwani S.S., Nisman M., Doroski V. Morphine-based cardiac anesthesia provides superior early recovery compared with fentanyl in elective cardiac surgery patients. Anesth. Analg. 2009; 109 (2):311-319. doi: 10.1213/ane.0b013e3181a90adc.
42. Taylor N.M., Lacoumenta S., Hall G.M. Fentanyl and the interleukin-6 response to surgery. Anaesthesia. 1997; 52 (2): 112-115.
43. Jacobs R., Karst M., Scheinichen D., Bevilacqua C., Schneider U., Heine J., Schedlowski M., Schmidt R.E. Effects of fentanyl on cellular immune functions in man. Int. J. Immunopharmacol. 1999; 21: 445-54. doi: 10.1016/s0192-0561(99)00025-9
44. Cassuto J., Sinclair R., Bonderovic M. Antiinflammatory properties of local anesthetics and their present and potential clinical implications. Acta Anaesthesiol. Scand. 2006; 50: 265-82. doi: 10.1111/j.1399-6576.2006.00936.x
45. Hahnenkamp K., Herroeder S., Hollmann M.W. Regional anaesthesia, local anaesthetics and the surgical stress response. Best Pract. Res. Clin. Anaesthesiol. 2004; 18: 50927. doi: 10.1016/j.bpa.2004.01.004
46. Toft P., T0nnesen E. The systemic inflammatory response to anaesthesia and surgery. Curr. Anaesth. Crit. Care. 2008; 19: 349-53. doi: 10.1016/j.cacc.2008.07.009
47. Homburger J.A., Meiler S.E. Anesthesia drugs, immunity, and long-term outcome. Curr. Opin. Anaesthesiol. 2006; 19: 423-8. doi: 10.1097/01.aco.0000236143.61593.14
48. Аджигалиев Р.Р., Баутин А.Е., Илов Н.Н., Пасюга В.В., Тарасов Д.Г Различное влияние наркотических анальгетиков на динамику активности цитокинов во время кардиохирургических вмешательств в условиях искусственного кровообращения. Вестн. анестезиол. и реаниматол. 2017; 14 (5): 34-40.
49. Sayed S., Maghraby H., Momen S., Hassan L., Asker F., Sayed D., Elgezawi E. Effect of morphine and fentanyl on inflammatory biomarkers in rheumatic heart patients undergoing valve replacement surgery. Anesth. Clin. Res. 2014, 5 (6): 41220. doi: 10.4172/2155-6148.1000412
Review
For citations:
Adzhigaliev R.R., Bautin A.E., Pasyuga V.V. Effects of general anesthesia on systemic inflammatory response during cardiac surgery with extracorporeal circulation. Complex Issues of Cardiovascular Diseases. 2019;8(4):145-152. (In Russ.) https://doi.org/10.17802/2306-1278-2019-8-4-145-152
Views:
562
