No Signs of Inflammation during Knee Surgery with Ischemia: A Study Involving Inhaled Nitric Oxide

Nitric oxide donors and inhaled nitric oxide (iNO) may decrease ischemia/reperfusion injury as reported in animal and human models. We investigated whether the attenuation of reperfusion injury, seen by others, in patients undergoing knee arthroplasty could be reproduced when patients had spinal ane...

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Main Authors: Lars Hållström, Claes Frostell, Anders Herrlin, Eva Lindroos, Ingrid Lundberg, Anne Soop
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Mediators of Inflammation
Online Access:http://dx.doi.org/10.1155/2014/620281
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author Lars Hållström
Claes Frostell
Anders Herrlin
Eva Lindroos
Ingrid Lundberg
Anne Soop
author_facet Lars Hållström
Claes Frostell
Anders Herrlin
Eva Lindroos
Ingrid Lundberg
Anne Soop
author_sort Lars Hållström
collection DOAJ
description Nitric oxide donors and inhaled nitric oxide (iNO) may decrease ischemia/reperfusion injury as reported in animal and human models. We investigated whether the attenuation of reperfusion injury, seen by others, in patients undergoing knee arthroplasty could be reproduced when patients had spinal anesthesia. 45 consecutive patients were randomized into three groups (n=15). Groups 1 and 3 were receiving iNO 80 ppm or placebo (nitrogen, N2) throughout the entire operation, and group 2 only received iNO in the beginning and at the end of the operation. Blood samples were collected before surgery, at the end of the surgery, and 2 hours postoperatively. Muscle biopsies were taken from quadriceps femoris muscle before and after ischemia. There were no increases in plasma levels of soluble adhesion molecules: ICAM, VCAM, P-selectin, E-selectin, or of HMGB1, in any of the groups. There were low numbers of CD68+ macrophages and of endothelial cells expression of ICAM, VCAM, and P-selectin in the muscle analyzed by immunohistochemistry, prior to and after ischemia. No signs of endothelial cell activation or inflammatory response neither systemically nor locally could be detected. The absence of inflammatory response questions this model of ischemia/reperfusion, but may also be related to the choice of anesthetic method EudraCTnr.
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spelling doaj-art-00c8d6bbcd8744c3a7fbe08a7e2992d12025-08-20T02:03:13ZengWileyMediators of Inflammation0962-93511466-18612014-01-01201410.1155/2014/620281620281No Signs of Inflammation during Knee Surgery with Ischemia: A Study Involving Inhaled Nitric OxideLars Hållström0Claes Frostell1Anders Herrlin2Eva Lindroos3Ingrid Lundberg4Anne Soop5Department of Clinical Science Intervention and Technology, Karolinska University Hospital-Karolinska Institute, 141 86 Stockholm, SwedenDepartment of Physiology and Pharmacology, Anesthesiology and Intensive Care Medicine, Karolinska University Hospital-Karolinska Institute, 141 86 Stockholm, SwedenDepartment of Orthopedic Surgery, Karolinska University Hospital-Karolinska Institute, 171 76 Stockholm, SwedenRheumatology Unit, Department of Medicine, Center for Molecular Medicine, Karolinska University Hospital-Karolinska Institute, 171 76 Stockholm, SwedenRheumatology Unit, Department of Medicine, Center for Molecular Medicine, Karolinska University Hospital-Karolinska Institute, 171 76 Stockholm, SwedenDepartment of Clinical Science Intervention and Technology, Karolinska University Hospital-Karolinska Institute, 141 86 Stockholm, SwedenNitric oxide donors and inhaled nitric oxide (iNO) may decrease ischemia/reperfusion injury as reported in animal and human models. We investigated whether the attenuation of reperfusion injury, seen by others, in patients undergoing knee arthroplasty could be reproduced when patients had spinal anesthesia. 45 consecutive patients were randomized into three groups (n=15). Groups 1 and 3 were receiving iNO 80 ppm or placebo (nitrogen, N2) throughout the entire operation, and group 2 only received iNO in the beginning and at the end of the operation. Blood samples were collected before surgery, at the end of the surgery, and 2 hours postoperatively. Muscle biopsies were taken from quadriceps femoris muscle before and after ischemia. There were no increases in plasma levels of soluble adhesion molecules: ICAM, VCAM, P-selectin, E-selectin, or of HMGB1, in any of the groups. There were low numbers of CD68+ macrophages and of endothelial cells expression of ICAM, VCAM, and P-selectin in the muscle analyzed by immunohistochemistry, prior to and after ischemia. No signs of endothelial cell activation or inflammatory response neither systemically nor locally could be detected. The absence of inflammatory response questions this model of ischemia/reperfusion, but may also be related to the choice of anesthetic method EudraCTnr.http://dx.doi.org/10.1155/2014/620281
spellingShingle Lars Hållström
Claes Frostell
Anders Herrlin
Eva Lindroos
Ingrid Lundberg
Anne Soop
No Signs of Inflammation during Knee Surgery with Ischemia: A Study Involving Inhaled Nitric Oxide
Mediators of Inflammation
title No Signs of Inflammation during Knee Surgery with Ischemia: A Study Involving Inhaled Nitric Oxide
title_full No Signs of Inflammation during Knee Surgery with Ischemia: A Study Involving Inhaled Nitric Oxide
title_fullStr No Signs of Inflammation during Knee Surgery with Ischemia: A Study Involving Inhaled Nitric Oxide
title_full_unstemmed No Signs of Inflammation during Knee Surgery with Ischemia: A Study Involving Inhaled Nitric Oxide
title_short No Signs of Inflammation during Knee Surgery with Ischemia: A Study Involving Inhaled Nitric Oxide
title_sort no signs of inflammation during knee surgery with ischemia a study involving inhaled nitric oxide
url http://dx.doi.org/10.1155/2014/620281
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