Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2015.08.002
Brazilian Journal of Anesthesiology
Scientific Article

Effect of dexmedetomidine on acute lung injury in experimental ischemia-reperfusion model

Efeito de dexmedetomidina sobre lesão pulmonar aguda em modelo experimental de isquemia-reperfusão

Ömer Burak Küçükebe; Deniz Özzeybek; Ruslan Abdullayev; Adil Ustaoğ; lu; Iş; ı; l Tekmen; Tuncay Küme

http://dx.doi.org/10.1016/j.bjane.2015.08.002 Braz J Anesthesiol, vol.67, n2, p.139-146, 2017
PDF English
PDF Português
Downloads: 0
Views: 560

Abstract

Abstract Purpose: Ischemia-reperfusion injury is one of the consequences of tourniquet application for extremity surgery. The aim of the study was to establish the effect of dexmedetomidine on the acute lung injury following lower extremity experimental ischemia-reperfusion model in rats. Methods: Twenty-eight Wistar-Albino breed Rats were recruited after Ethics Committee approval and allocated into 4 groups, each with 7 subjects. Group 1 (SHAM) received only anesthesia. Group 2 (IR) had experienced 3 h of ischemia and 3 h of reperfusion using left lower extremity tourniquet after anesthesia application. Groups 3 (D-50) and 4 (D-100) had undergone the same procedures as in the Group 2, except for receiving 50 and 100 mg·kg-1, respectively, dexmedetomidine intraperitoneally 1 h before the tourniquet release. Blood samples were obtained for the analysis of tumor necrosing factor-α and interleukin-6. Pulmonary tissue samples were obtained for histological analysis. Results: No significant difference regarding blood tumor necrosing factor-α and interleukin-6 values was found among the groups, whereas pulmonary tissue injury scores revealed significant difference. Histological scores obtained from the Group 2 were significantly higher from those in the Groups 1, 3 and 4 with p-values 0.001 for each comparison. Moreover, Group 1 scores were found to be significantly lower than those in the Groups 3 and 4 with p-values 0.001 and 0.011, respectively. No significant difference was observed between the Groups 3 and 4. Conclusion: Dexmedetomidine is effective in reduction of the experimental ischemia-reperfusion induced pulmonary tissue injury in rats, formed by extremity tourniquet application.

Keywords

Experimental, Dexmedetomidine, Reperfusion injury, Acute lung injury

Resumo

Resumo Objetivo: A lesão de isquemia-reperfusão é uma das consequências da aplicação do torniquete em cirurgias de extremidades. O objetivo do estudo foi determinar o efeito de dexmedetomidina em lesão pulmonar aguda após modelo experimental de isquemia-reperfusão em extremidade inferior de ratos. Métodos: Vinte e oito ratos albinos Wistar foram recrutados após aprovação do Comitê de Ética e alocados em quatro grupos, cada um com sete indivíduos. O Grupo 1 (Sham) recebeu apenas anestesia. O Grupo 2 (IR) foi submetido a 3 horas de isquemia e 3 horas de reperfusão com o uso de torniquete em extremidade inferior após a aplicação da anestesia. Os grupos 3 (D-50) e 4 (D-100) foram submetidos aos mesmos procedimentos do Grupo 2, exceto por receberem 50 e 100 mg.kg-1 de dexmedetomidina, respectivamente, por via intraperitoneal uma hora antes da liberação do torniquete. Amostras de sangue foram coletadas para análise de TNF-α e Interleucina-6 (IL-6). Amostras de tecido pulmonar foram coletadas para análise histológica. Resultados: Não houve diferença significativa quanto aos valores sanguíneos de TNF-α e IL-6 entre os grupos, enquanto os escores de lesão em tecidos pulmonares revelaram diferença significativa. Os escores histológicos obtidos no Grupo 2 foram significativamente maiores do que os dos grupos 1, 3 e 4, com valores-p de 0,001 para cada comparação. Além disso, os escores do Grupo 1 foram significativamente menores do que os dos grupos 3 e 4, com valores-p de 0,001 e 0,011, respectivamente. Não houve diferença significativa entre os grupos 3 e 4. Conclusão: Dexmedetomidina mostrou eficácia na redução de lesão em tecido pulmonar induzida por isquemia-reperfusão experimental em ratos, ocasionada por aplicação de torniquete em extremidade.

Palavras-chave

Experimental, Dexmedetomidina, Lesão de reperfusão, Lesão pulmonar aguda

References

Cerra FB, Lajos TZ, Montes M. Hemorrhagic infarction: a reperfusion injury following prolonged myocardial ischemic anoxia. Surgery. 1975;78:95-104.

Welbourn CR, Goldman G, Paterson IS. Pathophysiology of ischaemia reperfusion injury: central role of the neutrophil. Br J Surg. 1991;78:651-5.

Grace PA. Ischaemia-reperfusion injury. Br J Surg. 1994;81:637-47.

Vilcek J. The cytokines: an overview. The Cytokine Handbook. 2003;vol. 1:3-18.

Seekamp A, Mulligan MS, Till GO. Requirements for tumor necrosis factor-alpha and interleukin-1 in limb ischemia/reperfusion injury and associated lung injury. Am J Pathol. 1993;143:453-63.

Seekamp A, Till GO, Mulligan MS. Role of selectins in local and remote tissue injury following ischemia and reperfusion. Am J Pathol. 1994;144:592-8.

Yassin MM, Barros D'Sa AA, Parks G. Lower limb ischemia-reperfusion injury triggers a systemic inflammatory response and multiple organ dysfunction. World J Surg. 2002;26:115-21.

Maes M, Lin A, Kenis G. The effects of noradrenaline and alpha-2 adrenoceptor agents on the production of monocytic products. Psychiatry Res. 2000;96:245-53.

Venn RM, Bryant A, Hall GM. Preliminary UK experience of dexmedetomidine a novel agent for postoperative sedation in the intensive care unit. Anaesthesia. 1999;54:1136-42.

Bhana N, Goa KL, McClellan KJ. Dexmedetomidine. Drugs. 2000;59:263-70.

Taniguchi T, Kidani Y, Kanakura H. Effects of dexmedetomidine on mortality rate and inflammatory responses to endotoxin-induced shock in rats. Crit Care Med. 2004;32:1322-6.

Jolkkonen J, Puurunen K, Koistinaho J. Neuroprotection by the alpha2-adrenoceptor agonist, dexmedetomidine, in rat focal cerebral ischemia. Eur J Pharmacol. 1999;372:31-6.

Eser O, Fidan H, Sahin O. The influence of dexmedetomidine on ischemic rat hippocampus. Brain Res. 2008;1218:250-6.

Yagmurdur H, Ozcan N, Dokumaci F. Dexmedetomidine reduces the ischemia-reperfusion injury markers during upper extremity surgery with tourniquet. J Hand Surg Am. 2008;33:941-7.

Yang CL, Tsai PS, Huang CJ. Effects of dexmedetomidine on regulating pulmonary inflammation in a rat model of ventilator-induced lung injury. Acta Anaesthesiol Taiwan. 2008;46:151-9.

Kocoglu H, Ozturk H, Ozturk H. Effect of dexmedetomidine on ischemia-reperfusion injury in rat kidney: a histopathologic study. Ren Fail. 2009;31:70-4.

Tassiopoulos AP, Carlin RE, Gao Y. Role of nitric oxide and tumor necrosis factor on lung injury caused by ischemia/reperfusion of the lower extremities. J Vasc Surg. 1997;26:647-56.

Duru S, Koca U, Öztekin S. Antithrombin III pretreatment reduces neutrophil recruitment into the lung and skeletal muscle tissues in the rat model of bilateral lower limb and reperfusion: a pilot study. Acta Anaesthesiol Scand. 2005;49:1142-8.

Khalil AA, Aziz FA, Hall JC. Reperfusion injury. Plast Reconstr Surg. 2006;117:1024-33.

Blaisdell FW. The pathophysiology of skeletal muscle ischemia and the reperfusion syndrome: a review. Cardiovasc Surg. 2002;10:620-30.

Petrasek PF, Homer-Vanniasinkam S, Walker PM. Determinants of ischemic injury to skeletal muscle. J Vasc Surg. 1994;19:623-31.

Seal JB, Gewertz BL. Vascular dysfunction in ischemia-reperfusion injury. Ann Vasc Surg. 2005;19:572-84.

Yao YM, Sheng ZY, Yu Y. The potential etiologic role of tumor necrosis factor in mediating multiple organ dysfunction in rats following intestinal ischemia-reperfusion injury. Resuscitation. 1995;29:157-68.

Roumen RM, Hendriks T, van der Ven-Jonge KJ. Cytokine patterns in patients after major vascular surgery, hemorrhagic shock, and severe blunt trauma. Relation with subsequent adult respiratory distress syndrome and multiple organ failure. Ann Surg. 1993;218:769-76.

Koroglu A, Demirbilek S, Teksan H. Sedative, haemodynamic and respiratory effects of dexmedetomidine in children undergoing magnetic resonance imaging examination: preliminary results. Br J Anaesth. 2005;94:821-4.

Arain SR, Ruehlow RM, Uhrich TD. The efficacy of dexmedetomidine versus morphine for postoperative analgesia after major inpatient surgery. Anesth Analg. 2004;98:153-8.

Shen J, Fu G, Jiang L. Effect of dexmedetomidine pretreatment on lung injury following intestinal ischemia-reperfusion. Exp Ther Med. 2013;6:1359-64.

Engelhard K, Werner C, Eberspacher E. The effect of the alpha 2-agonist dexmedetomidine and the N-methyl-D-aspartate antagonist S(+)-ketamine on the expression of apoptosis-regulating proteins after incomplete cerebral ischemia and reperfusion in rats. Anesth Analg. 2003;96:524-31.

Welbourn R, Goldman G, O'Riordain M. Role for tumor necrosis factor as mediator of lung injury following lower torso ischemia. J Appl Physiol. 1991;70:2645-9.

Harkin DW, Barros D'Sa AA, McCallion K. Ischemic preconditioning before lower limb ischemia-reperfusion protects against acute lung injury. J Vasc Surg. 2002;35:1264-73.

Gaines GC, Welborn 3rd MB, Moldawer LL. Attenuation of skeletal muscle ischemia/reperfusion injury by inhibition of tumor necrosis factor. J Vasc Surg. 1999;29:370-6.

5dcd90ed0e8825dc21bf58f3 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections