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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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2014/620281 |
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| _version_ | 1850232400578084864 |
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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. |
| format | Article |
| id | doaj-art-00c8d6bbcd8744c3a7fbe08a7e2992d1 |
| institution | OA Journals |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| 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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