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Van Allen NR, Krafft PR, Leitzke AS, et al. The role of Volatile Anesthetics in Cardioprotection: a systematic review. Med Gas Res. 2012;2(1):22doi: 10.1186/2045-9912-2-22.
Van Allen, N. R., Krafft, P. R., Leitzke, A. S., Applegate, R. L., Tang, J., & Zhang, J. H. (2012). The role of Volatile Anesthetics in Cardioprotection: a systematic review. Medical gas research, 2(1), 22. https://doi.org/10.1186/2045-9912-2-22
Van Allen, Nicole R, et al. "The role of Volatile Anesthetics in Cardioprotection: a systematic review." Medical gas research vol. 2,1 (2012): 22. doi: https://doi.org/10.1186/2045-9912-2-22
Van Allen NR, Krafft PR, Leitzke AS, Applegate RL, Tang J, Zhang JH. The role of Volatile Anesthetics in Cardioprotection: a systematic review. Med Gas Res. 2012 Aug 28;2(1):22. doi: 10.1186/2045-9912-2-22. PMID: 22929111; PMCID: PMC3598931.
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Med Gas Res. 2012 Aug 28;2(1):22. doi: 10.1186/2045-9912-2-22.

The role of Volatile Anesthetics in Cardioprotection: a systematic review.

Medical gas research

Nicole R Van Allen, Paul R Krafft, Arthur S Leitzke, Richard L Applegate, Jiping Tang, John H Zhang

Affiliations

  1. Department of Physiology, Loma Linda University School of Medicine, Risley Hall, Room 223, Loma Linda, CA 92354, USA. [email protected].

PMID: 22929111 PMCID: PMC3598931 DOI: 10.1186/2045-9912-2-22

Abstract

This review evaluates the mechanism of volatile anesthetics as cardioprotective agents in both clinical and laboratory research and furthermore assesses possible cardiac side effects upon usage. Cardiac as well as non-cardiac surgery may evoke perioperative adverse events including: ischemia, diverse arrhythmias and reperfusion injury. As volatile anesthetics have cardiovascular effects that can lead to hypotension, clinicians may choose to administer alternative anesthetics to patients with coronary artery disease, particularly if the patient has severe preoperative ischemia or cardiovascular instability. Increasing preclinical evidence demonstrated that administration of inhaled anesthetics - before and during surgery - reduces the degree of ischemia and reperfusion injury to the heart. Recently, this preclinical data has been implemented clinically, and beneficial effects have been found in some studies of patients undergoing coronary artery bypass graft surgery. Administration of volatile anesthetic gases was protective for patients undergoing cardiac surgery through manipulation of the potassium ATP (KATP) channel, mitochondrial permeability transition pore (mPTP), reactive oxygen species (ROS) production, as well as through cytoprotective Akt and extracellular-signal kinases (ERK) pathways. However, as not all studies have demonstrated improved outcomes, the risks for undesirable hemodynamic effects must be weighed against the possible benefits of using volatile anesthetics as a means to provide cardiac protection in patients with coronary artery disease who are undergoing surgery.

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