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Table 1 Clinical studies of the protective effects of VAs

From: Comparison of volatile anesthetic-induced preconditioning in cardiac and cerebral system: molecular mechanisms and clinical aspects

  Surgery Patients and number (n) Volatile anesthetics and dose Outcome Refs.
Cardioprotection Cardiopulmonary bypass n = 200 Sevoflurane
0.5–2%
Increase of troponin I ↓
Cardiac output ↑
Inotropic support ↓
Duration of stay in the ICU and hospital ↓
De Hert et al. [79]
Cardiopulmonary bypass Elderly high-riska patients, n = 45 Sevoflurane
0.5–2%
Desflurane
1–4%
Decrease in cardiac index (CI) post-CPB ↓
Inotropic support ↓
De Hert et al. [80]
Off-pump coronary artery bypass grafting n = 48 Sevoflurane
1.0 MAC and 1.5 MAC
Post-surgical cardiac Troponin I ↓ Wang et al. [81]
Off-pump coronary artery bypass n = 45 Isoflurane
1.0–2.5%
Post-surgical cardiac index ↑
Increase of troponin T ↓
Tempe et al. [83]
Off-pump coronary artery bypass n = 60 Sevoflurane
0.7 and 1 MAC
Increase of troponin I ↓
Postoperative NT-proBNPb
Inotropic support ↓
Guerrero Orriach et al. [84]
On-pump coronary artery bypass n = 45 Isoflurane 2.5%
10 minc
Hemodynamic recovery ↑
Cardiac troponin T ↓
CK-MB release ↓
Inotropic support ↓
Amr et al. [85]
Cerebral protection Cardiopulmonary bypass n = 128 Sevoflurane
0.6–1 MAC
Cognitive function ↑ Schoen et al. [91]
Cardiopulmonary bypass n = 92 Sevoflurane
0.5 MAC
Isoflurane
0.5 MAC
Postoperative Mg disorders ↓
Increase in plasma MMP-9 and GFAPd concentration ↓
Dabrowski et al. [92]
  1. CPB cardiopulmonary bypass, MAC minimal alveolar concentration
  2. aElderly high-risk: older than 70 years with three-vessel disease and an ejection fraction less than 50% with impaired length-dependent regulation of myocardial function
  3. bN-terminal pro-brain natriuretic peptide
  4. cPreconditioning with a 10-min exposure to isoflurane 2.5% followed by 5-min washout
  5. dSensitive marker of brain injury: matrix metalloproteinase-9 (MMP-9), glial fibrillary acidic protein (GFAP)