Cardioprotection by volatile anesthetics: new applications for old drugs? Curr Opin Anaesthesiol 2006 Aug;19(4):397-403
Date
07/11/2006Pubmed ID
16829721DOI
10.1097/01.aco.0000236139.31099.b5Scopus ID
2-s2.0-33745894991 (requires institutional sign-in at Scopus site) 31 CitationsAbstract
PURPOSE OF REVIEW: Pharmacological interventions may play a prominent role in reducing organ damage in response to physiologic stress. A growing body of evidence indicates that volatile anesthetics exert protective effects against ischemia-reperfusion injury in vivo. Administration of volatile anesthetics before prolonged coronary artery occlusion and reperfusion has been shown to produce cardioprotection, a phenomenon termed anesthetic-induced preconditioning. Endogenous signal transduction proteins, reactive oxygen species, mitochondria, and ion channels have been implicated in anesthetic-induced preconditioning, and new data regarding the triggering and effector roles for these various components have been discovered that advance our understanding of the mechanisms responsible for anesthetic-induced preconditioning. This review will update and integrate these recent data into the current mechanistic model of anesthetic-induced preconditioning.
RECENT FINDINGS: Despite a wealth of data from animal studies, the mechanism by which preconditioning with volatile anesthetics alleviates ischemic injury remains incompletely understood. Recent data have identified important interactions between reactive oxygen species and key intracellular signal transduction enzymes and proteins implicated in anesthetic-induced preconditioning.
SUMMARY: This review highlights the major recent findings examining mechanisms of volatile anesthetic cardioprotection.
Author List
Pratt PF Jr, Wang C, Weihrauch D, Bienengraeber MW, Kersten JR, Pagel PS, Warltier DCAuthors
Paul S. Pagel MD, PhD Professor in the Anesthesiology department at Medical College of WisconsinDorothee Weihrauch DVM, PhD Research Scientist II in the Anesthesiology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Anesthetics, InhalationApoptosis
Cardiotonic Agents
Heart Diseases
Humans
KATP Channels
Mitochondria
Permeability
Potassium Channels, Inwardly Rectifying
Reactive Oxygen Species
Signal Transduction