Abstract
Halogenated anesthetic agents (desflurane, isoflurane and sevoflurane) may have cardioprotective properties at therapeutic doses against myocardial intraoperative ischemia-reperfusion injury. Cardioprotection mechanisms are related to mitochondrial and anti-apoptotic signaling pathways. Experimentals and human studies have proven that their use may reduce morbidity and mortality in the setting of cardiac surgery, including a reduction in myocardial infarct size and mechanical ventilation needs. In contrast, total intra-venous propofol based anesthesia may be detrimental. In the present review, we show the rationale for the perioperative use of halogenated anesthetics based on mechanisms of action, experimental research and human studies. Considerations and major concerns regarding their use, the present evidence for their use in other areas, such as major non-cardiac surgery and intensive care unit patients, and future perspectives are also discussed.
Keywords: Halogenated agents, total intra-venous anesthesia, cardiac surgery, outcomes, intensive care unit, anesthesia, intensive care.
Graphical Abstract
Current Vascular Pharmacology
Title:Halogenated Agents and Cardiovascular Surgery: Has Mortality Really Decreased?
Volume: 16 Issue: 4
Author(s): Giovanni Landoni*, Juan Carlos Lopez-Delgado, Chiara Sartini, Simona Tamà and Alberto Zangrillo
Affiliation:
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan,Italy
Keywords: Halogenated agents, total intra-venous anesthesia, cardiac surgery, outcomes, intensive care unit, anesthesia, intensive care.
Abstract: Halogenated anesthetic agents (desflurane, isoflurane and sevoflurane) may have cardioprotective properties at therapeutic doses against myocardial intraoperative ischemia-reperfusion injury. Cardioprotection mechanisms are related to mitochondrial and anti-apoptotic signaling pathways. Experimentals and human studies have proven that their use may reduce morbidity and mortality in the setting of cardiac surgery, including a reduction in myocardial infarct size and mechanical ventilation needs. In contrast, total intra-venous propofol based anesthesia may be detrimental. In the present review, we show the rationale for the perioperative use of halogenated anesthetics based on mechanisms of action, experimental research and human studies. Considerations and major concerns regarding their use, the present evidence for their use in other areas, such as major non-cardiac surgery and intensive care unit patients, and future perspectives are also discussed.
Export Options
About this article
Cite this article as:
Landoni Giovanni *, Lopez-Delgado Carlos Juan , Sartini Chiara , Tamà Simona and Zangrillo Alberto , Halogenated Agents and Cardiovascular Surgery: Has Mortality Really Decreased?, Current Vascular Pharmacology 2018; 16 (4) . https://dx.doi.org/10.2174/1570161115666171010121549
DOI https://dx.doi.org/10.2174/1570161115666171010121549 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The Effect of Lipoic Acid on Macro and Trace Metal Levels in Living Tissues Exposed to Oxidative Stress
Anti-Cancer Agents in Medicinal Chemistry Functional and Molecular Ultrasound Imaging: Concepts and Contrast Agents
Current Medicinal Chemistry Perspectives and New Aspects of Metalloproteinases’ Inhibitors in the Therapy of CNS Disorders: From Chemistry to Medicine
Current Medicinal Chemistry Protein Kinase C-Related Kinase (PKN/PRK). Potential Key-Role for PKN1 in Protection of Hypoxic Neurons
Current Neuropharmacology Acute Effects of Neutrophil-Derived Oxidative Stress on Pulmonary Microvasculature
Current Respiratory Medicine Reviews Biological and Pharmacological Activities of Iridoids: Recent Developments
Mini-Reviews in Medicinal Chemistry Phytocannabinoids and Cannabimimetic Drugs: Recent Patents in Central Nervous System Disorders
Recent Patents on CNS Drug Discovery (Discontinued) Insulin Resistance and Endothelial Dysfunction: A Mutual Relationship in Cardiometabolic Risk
Current Pharmaceutical Design A Review of Systemic Vasodilators in Low Cardiac Output Syndrome Following Pediatric Cardiac Surgery
Current Vascular Pharmacology Flavonoids and Dementia: An Update
Current Medicinal Chemistry Hypercoagulability in Sickle Cell Disease and Beta-Thalassemia
Current Molecular Medicine Synthesis and Biological Activity of a Bis-steroid-methanocyclobutanaphthalene- dione Derivative against Ischemia/Reperfusion Injury via Calcium Channel Activation
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Influence of Gender on C-Reactive Protein, Fibrinogen, and Erythrocyte Sedimentation Rate in Obstructive Sleep Apnea
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Salvianolic Acid A Attenuates Cell Apoptosis, Oxidative Stress, Akt and NF-κB Activation in Angiotensin-II Induced Murine Peritoneal Macrophages
Current Pharmaceutical Biotechnology Overview of Systems Biology and Omics Technologies
Current Medicinal Chemistry Understanding the Multifaceted Role of Inflammatory Mediators in Ischemic Stroke
Current Medicinal Chemistry Protease Inhibitors in the Clinic
Medicinal Chemistry Saccharide Modified Pharmaceutical Nanocarriers for Targeted Drug and Gene Delivery
Current Pharmaceutical Design Modulation of Neuro-Inflammation and Vascular Response by Oxidative Stress Following Cerebral Ischemia-Reperfusion Injury
Current Medicinal Chemistry Peroxisome Proliferator-Activated Receptor-γ (PPAR-γ) Ligands: Novel Pharmacological Agents in the Treatment of Ischemia Reperfusion Injury
Current Molecular Medicine