Δημοσίευση

Effects of isoflurane anesthesia on aortic compliance and systemic hemodynamics in compliant and noncompliant aortas.

ΤίτλοςEffects of isoflurane anesthesia on aortic compliance and systemic hemodynamics in compliant and noncompliant aortas.
Publication TypeJournal Article
Year of Publication2013
AuthorsIoannou, C. V., Stergiopulos N., Georgakarakos E., Chatzimichali E., Katsamouris A. N., & Morel D. R.
JournalJ Cardiothorac Vasc Anesth
Volume27
Issue6
Pagination1282-8
Date Published2013 Dec
ISSN1532-8422
Λέξεις κλειδιάAnesthesia, General, Anesthesia, Inhalation, Anesthetics, Inhalation, Animals, Aorta, Blood Pressure, Blood Vessel Prosthesis, Cardiac Surgical Procedures, Compliance, Hemodynamics, Isoflurane, Pressoreceptors, Swine, Swine, Miniature, Vascular Stiffness
Abstract

OBJECTIVES: To investigate the effect of general anesthesia on aortic compliance and other cardiovascular hemodynamics in chronically instrumented pigs with compliant and noncompliant (stiff) aortas.DESIGN: Experimental study.SETTING: University animal laboratory.PARTICIPANTS: Twelve adult Yucatan miniature pigs.INTERVENTIONS: Chronic instrumentation of a compliant (control; n = 7) and noncompliant (n = 5) group to measure pressure and flow in the ascending aorta. A Teflon prosthesis was wrapped around the aorta (noncompliant group) to limit wall compliance.MEASUREMENTS AND MAIN RESULTS: Hemodynamic parameters were recorded on the 15th postoperative day, both awake and after general anesthesia. Banding the aorta caused a significant decrease in arterial compliance (-49%, p<0.001) and increases in systolic blood pressure (SBP: +38%, p = 0.001) and pulse pressure (+107%, p< 0.01). Induction of anesthesia in the control group produced a 15% increase in arterial compliance (p<0.05), resulting in a subtle decrease in SBP (-12%), diastolic blood pressure (DBP; -13%) and mean blood pressure (MBP; -12%). Induction of anesthesia in the noncompliant group also caused a significant increase in arterial compliance (17%, p<0.001), but caused significant decreases in SBP (21%, p<0.01), DBP (23%, p<0.01) and MBP (22%, p<0.01) as compared with controls.CONCLUSIONS: Induction of general anesthesia caused a similar increase in total arterial compliance and was associated with a decrease in SBP that was more pronounced in animals with noncompliant aortas. These results indicated that anesthesia caused a greater hemodynamic effect on noncompliant (stiff) aortas and may explain the extensive hemodynamic fluctuation and instability often observed in atherosclerotic, elderly patients with stiff aortas.

DOI10.1053/j.jvca.2013.04.015
Alternate JournalJ. Cardiothorac. Vasc. Anesth.
PubMed ID24035064

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