The primary objective of this review is to evaluate the anti-inflammatory effects of volatile sedative agents compared with intravenous sedative agents in animal pre-clinical studies with a focus on pulmonary and plasma markers of inflammation in models of acute respiratory failure, sepsis and shock. Perioperative and critical care patients have an altered inflammatory response that is replicated in experimental animal models. Such models allow researchers to capture relevant post-morten pathology and cytological data that are not readily available in human studies. Volatile agents exert measurable anti-inflammatory and immunomodulatory effects that have therefore only been partially described in human subjects. There exists significant pre-clinical research in animal models that may translate into relevant and beneficial clinical outcomes for human patients.

This systematic review aims to answer the following questions:

1. Do volatile anesthetics, compared with intravenous agents, reduce the pulmonary alveolar and/or systemic inflammatory response in animal models of acute respiratory failure, lung injury, sepsis and shock?
2. To what degree do volatile anesthetics, compared with intravenous agents, reduce markers of endothelial damage/dysfunction in such models?
3. Do volatile anesthetics, compared with intravenous agents, modulate coagulopathy and thrombogenesis in such models?
4. Which specific markers of inflammation, endothelial damage, and coagulopathy are involved in these clinical effects, and are they measurable in plasma and broncho-alveolar lavage fluid?

Soroush Rouhani

Aly Balbaa

Angela Jerath

Beverly Orser

Douglas Fraser

Kirusanthy Kaneshwaran

Marat Slessarev

Coming soon