Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in Patients
Inhalation anesthetic isoflurane inhibits hypoxia pulmonary vasoconstriction (HPV), while dexmedetomidine (Dex) could reduce the dose of isoflurane inhalation and potentiate HPV, but the mechanism is unclear. Inhibition of reactive oxygen species (ROS) production can favor HPV during one-lung ventil...
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Wiley
2015-01-01
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| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2015/238041 |
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| author | Rui Xia Jinjin Xu Hong Yin Huozhi Wu Zhengyuan Xia Daiwei Zhou Zhong-yuan Xia Liangqing Zhang Haobo Li Xiaoshan Xiao |
| author_facet | Rui Xia Jinjin Xu Hong Yin Huozhi Wu Zhengyuan Xia Daiwei Zhou Zhong-yuan Xia Liangqing Zhang Haobo Li Xiaoshan Xiao |
| author_sort | Rui Xia |
| collection | DOAJ |
| description | Inhalation anesthetic isoflurane inhibits hypoxia pulmonary vasoconstriction (HPV), while dexmedetomidine (Dex) could reduce the dose of isoflurane inhalation and potentiate HPV, but the mechanism is unclear. Inhibition of reactive oxygen species (ROS) production can favor HPV during one-lung ventilation (OLV). Similarly, nitric oxide (NO), an important endothelium-derived vasodilator in lung circulation, can decrease the regional pulmonary vascular resistance of ventilated lung and reduce intrapulmonary shunting. We hypothesized that Dex may augment HPV and improve oxygenation during OLV through inhibiting oxidative stress and increasing NO release. Patients undergoing OLV during elective thoracic surgery were randomly allocated to either isoflurane + saline (NISO, n=24) or isoflurane + dexmedetomidine (DISO, n=25) group. Anesthesia was maintained with intravenous remifentanil and inhalational isoflurane (1.0–2.0%), with concomitant infusion of dexmedetomidine 0.7 μgkg−1h−1 in DISO and saline 0.25 mL kg−1h−1 in NISO group. Hemodynamic variables or depth of anesthesia did not significantly differ between groups. Administration of Dex significantly reduced Qs/Qt and increased PaO2 after OLV, accompanied with reduced lipid peroxidation product malondialdehyde and higher levels of SOD activity as well as serum NO (all P<0.05 DISO versus NISO). In conclusion, reducing oxidative stress and increasing NO release during OLV may represent a mechanism whereby Dex potentiates HPV. |
| format | Article |
| id | doaj-art-b1ed88bf03764163912b57bcb271be0c |
| institution | Kabale University |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-b1ed88bf03764163912b57bcb271be0c2025-02-03T06:11:31ZengWileyMediators of Inflammation0962-93511466-18612015-01-01201510.1155/2015/238041238041Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in PatientsRui Xia0Jinjin Xu1Hong Yin2Huozhi Wu3Zhengyuan Xia4Daiwei Zhou5Zhong-yuan Xia6Liangqing Zhang7Haobo Li8Xiaoshan Xiao9Department of Anesthesiology, First Affiliated Hospital, Yangtze University, Jingzhou 434000, ChinaDepartment of Anesthesiology, Wuhan University Renmin Hospital, Wuhan 430060, ChinaDepartment of Anesthesiology, First Affiliated Hospital, Yangtze University, Jingzhou 434000, ChinaDepartment of Cardiothoracic Surgery, Fifth Affiliated Hospital of Zunyi Medical College, Zhuhai 519100, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, ChinaDepartment of Anesthesiology, Guangdong No. 2 Provincial People’s Hospital, Guangdong Provincial Emergency Hospital, Guangzhou, Guangdong 510317, ChinaDepartment of Anesthesiology, Wuhan University Renmin Hospital, Wuhan 430060, ChinaDepartment of Anesthesiology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001, ChinaDepartment of Anesthesiology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001, ChinaDepartment of Anesthesiology, Guangdong No. 2 Provincial People’s Hospital, Guangdong Provincial Emergency Hospital, Guangzhou, Guangdong 510317, ChinaInhalation anesthetic isoflurane inhibits hypoxia pulmonary vasoconstriction (HPV), while dexmedetomidine (Dex) could reduce the dose of isoflurane inhalation and potentiate HPV, but the mechanism is unclear. Inhibition of reactive oxygen species (ROS) production can favor HPV during one-lung ventilation (OLV). Similarly, nitric oxide (NO), an important endothelium-derived vasodilator in lung circulation, can decrease the regional pulmonary vascular resistance of ventilated lung and reduce intrapulmonary shunting. We hypothesized that Dex may augment HPV and improve oxygenation during OLV through inhibiting oxidative stress and increasing NO release. Patients undergoing OLV during elective thoracic surgery were randomly allocated to either isoflurane + saline (NISO, n=24) or isoflurane + dexmedetomidine (DISO, n=25) group. Anesthesia was maintained with intravenous remifentanil and inhalational isoflurane (1.0–2.0%), with concomitant infusion of dexmedetomidine 0.7 μgkg−1h−1 in DISO and saline 0.25 mL kg−1h−1 in NISO group. Hemodynamic variables or depth of anesthesia did not significantly differ between groups. Administration of Dex significantly reduced Qs/Qt and increased PaO2 after OLV, accompanied with reduced lipid peroxidation product malondialdehyde and higher levels of SOD activity as well as serum NO (all P<0.05 DISO versus NISO). In conclusion, reducing oxidative stress and increasing NO release during OLV may represent a mechanism whereby Dex potentiates HPV.http://dx.doi.org/10.1155/2015/238041 |
| spellingShingle | Rui Xia Jinjin Xu Hong Yin Huozhi Wu Zhengyuan Xia Daiwei Zhou Zhong-yuan Xia Liangqing Zhang Haobo Li Xiaoshan Xiao Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in Patients Mediators of Inflammation |
| title | Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in Patients |
| title_full | Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in Patients |
| title_fullStr | Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in Patients |
| title_full_unstemmed | Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in Patients |
| title_short | Intravenous Infusion of Dexmedetomidine Combined Isoflurane Inhalation Reduces Oxidative Stress and Potentiates Hypoxia Pulmonary Vasoconstriction during One-Lung Ventilation in Patients |
| title_sort | intravenous infusion of dexmedetomidine combined isoflurane inhalation reduces oxidative stress and potentiates hypoxia pulmonary vasoconstriction during one lung ventilation in patients |
| url | http://dx.doi.org/10.1155/2015/238041 |
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