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Sub-MAC concentrations of desflurane do not inhibit hypoxic pulmonary vasoconstriction in anesthetized piglets

[La vasoconstriction pulmonaire hypoxique n'est pas inhibée par des concentrations de desflurane inférieures à la CAM chez des porcelets anesthésiés]

F. Kerbaul, MD^*, C. Guidon, MD^*, J. Stephanazzi, MD, M. Bellezza, MD^*, P. Le Dantec , MD, T. Longeon and M. Aubert, MD

^* From the Departments of Anesthésie-Réanimation Adulte, Groupe Hospitalier de La Timone, Marseilles;
Anesthésie-Réanimation, Hôpital Percy, Paris;
Anesthésie-Réanimation, Hôpital Sainte Anne, Toulon Armées; and
Anesthésie-Réanimation, Hôpital d'Instruction des Armées Laveran, Marseilles, France.

Address correspondence to: Dr. François Kerbaul, Département d'Anesthésie-Réanimation Adulte, Groupe Hospitalier de La Timone, 264 rue Saint Pierre, 13385 Marseille Cedex 05, France. Phone: 04-91-38-57-91; Fax: 04-91-38-58-50; E-mail: fkerbaul{at}yahoo.fr Institution: IMTSSA, Parc du Pharo, 13998 Marseille Armées.

Purpose: In vitro, halogenated agents reduce the pulmonary vasoconstrictor response to alveolar hypoxia in isolated perfused lungs. However, studies in intact animals have been less convincing. The aim of the present study was to assess the effect of sub-MAC concentrations of desflurane on hypoxic pulmonary vasoconstriction (HPV) in anesthetized piglets using the pressure/cardiac output relationship (P/Q).

Methods: Eleven large white piglets were anesthetized and ventilated mechanically, alternatively in hyperoxia (FIO₂=0.4) and in hypoxia (FIO₂=0.12). Multipoint plots of pulmonary arterial pressure (PAP), or differences between PAP and left atrial pressure (LAP) against Q were generated by gradual inflation of a balloon advanced into the inferior vena cava. P/Q relationships were established in hyperoxia and in hypoxia at baseline, and then with gradual concentrations of desflurane.

Results: In hypoxia, pressure gradients (PAP-LAP) increased significantly at every level of Q, demonstrating active pulmonary vasoconstriction. Desflurane did not affect these P/Q relationships either in hyperoxia, or in hypoxia, when compared with baseline.

Conclusion: Desflurane at a clinically relevant dose has no significant effect on HPV in anesthetized piglets.

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