Volatile Anesthetic Attenuates Phagocyte Function and Worsens Bacterial Loads in Wounds
Volatile Anesthetic Attenuates Phagocyte Function and Worsens Bacterial Loads in Wounds
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DOI：
10.1016/j.jss.2018.07.075
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发表时间：
2019-01-01
影响因子：
2.2
通讯作者：
Yuki, Koichi
中科院分区：
文献类型：
--
作者：
Koutsogiannaki, Sophia;Bernier, Rachel;Yuki, Koichi
背景资料：以前，我们已经表明，挥发性麻醉剂异氟烷衰减中性粒细胞的招聘和吞噬作用，在小鼠败血症和皮肤炎症模型。本研究的目的是测试在挥发性麻醉与静脉麻醉（IA）下接受心导管插入术的患者中中性粒细胞的离体功能，并使用小鼠模型评估麻醉对手术部位感染（SSI）的影响，以了解麻醉诱导的免疫调节的临床相关性。收集通过挥发性麻醉或IA进行心导管插入术的患者的全血，并进行吞噬试验和脂多糖诱导的肿瘤坏死因子-α试验。小鼠SSI与金黄色葡萄球菌USA 300的创建，异氟烷和丙泊酚暴露（短期或长期暴露）对细菌loads.Results的影响：吸入麻醉诱导后，患者的中性粒细胞吞噬功能显着减弱，但不是由IA。单核细胞吞噬作用不受麻醉方案的影响。SSI后的细菌负荷在接受长时间（而非短时间）异氟烷暴露的小鼠中显著更高。异丙酚暴露并不影响细菌load.Discussion：中性粒细胞吞噬作用可以受到麻醉类型的影响，SSI的临床前模型显示出潜在的临床相关性。麻醉方案对患者SSI的影响需要在未来进行广泛的研究。(C)2018爱思唯尔公司All rights reserved.
Background: Previously we have shown that volatile anesthetic isoflurane attenuated neutrophil recruitment and phagocytosis in mouse sepsis and skin inflammation models. The objectives of this study were to test ex vivo function of neutrophils in patients who underwent cardiac catheterization under volatile anesthesia versus intravenous anesthesia (IA), and also to assess the effect of anesthesia on surgical site infections (SSIs) using mouse model to understand the clinical relevance of anesthesia-induced immunomodulation.Methods: Whole blood from patients who underwent cardiac catheterization procedures either by volatile anesthesia or IA was collected and subjected to phagocytosis assay and a lipopolysaccharide-induced tumor necrosis factor-alpha assay. Mouse SSI with Staphylococcus aureus USA300 was created, and the effect of isoflurane and propofol exposure (short or long exposure) on bacterial loads was tested.Results: Neutrophil phagocytosis was significantly attenuated after the induction of volatile anesthesia in patients, but not by IA. Monocyte phagocytosis was not affected by the anesthesia regimen. Bacterial loads following SSIs were significantly higher in mice receiving long, but not short, isoflurane exposure. Propofol exposure did not affect bacterial loads.Discussion: Neutrophil phagocytosis can be affected by the type of anesthesia, and pre-clinical model of SSIs showed potential clinical relevance. The effects of anesthesia regimen on SSIs in patients needs to be studied extensively in the future. (C) 2018 Elsevier Inc. All rights reserved.