Halogenated anaesthetics and cardiac protection in cardiac and non-cardiac anaesthesia

Autor: Giovanni Landoni, Alberto Zangrillo, Elena Bignami, Fochi Oliviero
Přispěvatelé: Landoni, Giovanni, Bignami, E, Oliviero, F, Zangrillo, Alberto
Rok vydání: 2009
Předmět:
Inotrope
Methyl Ethers
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system
Myocardial Infarction
Sevoflurane
law.invention
Anaesthesia
lcsh:RD78.3-87.3
Desflurane
law
Internal medicine
medicine
Humans
General anaesthesia
Myocardial infarction
Coronary Artery Bypass
Randomized Controlled Trials as Topic
Evidence-Based Medicine
Isoflurane
business.industry
Incidence
Troponin I
General Medicine
Perioperative
medicine.disease
Intensive care unit
mortality
Cardiac surgery
Anesthesiology and Pain Medicine
lcsh:Anesthesiology
lcsh:RC666-701
Anesthesia
Surgical Procedures
Operative
volatile anaesthetics
Anesthetics
Inhalation
Ischemic Preconditioning
Myocardial
Practice Guidelines as Topic
Cardiology
Cardiology and Cardiovascular Medicine
business
cardiac surgery
medicine.drug
Zdroj: Annals of Cardiac Anaesthesia, Vol 12, Iss 1, Pp 4-9 (2009)
ISSN: 0974-5181
Popis: Volatile anaesthetic agents have direct protective properties against ischemic myocardial damage. The implementation of these properties during clinical anaesthesia can provide an additional tool in the treatment or prevention, or both, of ischemic cardiac dysfunction in the perioperative period. A recent meta-analysis showed that desflurane and sevoflurane reduce postoperative mortality and incidence of myocardial infarction following cardiac surgery, with significant advantages in terms of postoperative cardiac troponin release, need for inotrope support, time on mechanical ventilation, intensive care unit and overall hospital stay. Multicentre, randomised clinical trials had previously demonstrated that the use of desflurane can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalisation following coronary artery bypass graft surgery either with and without cardiopulmonary bypass. The American College of Cardiology/American Heart Association Guidelines recommend volatile anaesthetic agents during non-cardiac surgery for the maintenance of general anaesthesia in patients at risk for myocardial infarction. Nonetheless, e vidence in non-coronary surgical settings is contradictory and will be reviewed in this paper together with the mechanisms of cardiac protection by volatile agents.
Databáze: OpenAIRE
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