The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples
Abstract Desflurane, isoflurane and sevoflurane, three halogenated ethers, are commonly used inhaled anesthetics, both in the operating room and in the intensive care unit (ICU). The potency and dosage of these drugs is expressed by the MAC value (minimum alveolar concentration). Their interaction w...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-08-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-17789-6 |
| _version_ | 1798042638439415808 |
|---|---|
| author | Marco Ronzani Simon Woyke Norbert Mair Hannes Gatterer Herbert Oberacher David Plunser Thomas Haller Mathias Ströhle Christopher Rugg |
| author_facet | Marco Ronzani Simon Woyke Norbert Mair Hannes Gatterer Herbert Oberacher David Plunser Thomas Haller Mathias Ströhle Christopher Rugg |
| author_sort | Marco Ronzani |
| collection | DOAJ |
| description | Abstract Desflurane, isoflurane and sevoflurane, three halogenated ethers, are commonly used inhaled anesthetics, both in the operating room and in the intensive care unit (ICU). The potency and dosage of these drugs is expressed by the MAC value (minimum alveolar concentration). Their interaction with hemoglobin and its affinity for oxygen, best described by the oxygen dissociation curve (ODC), has already been investigated, with conflicting results. Altered by many factors, the ODC can be shifted to the left or to the right, therefore increasing or decreasing hemoglobin oxygen (Hb-O2) affinity. In venous blood samples of 22 healthy participants (11 female, 11 male) ODC were measured with a high-throughput method in vitro. Blood samples were either exposed to control or to three different concentrations of desflurane, isoflurane or sevoflurane prior to and during measurements (low, medium and high corresponding to MAC 0.5, MAC 1.0 and MAC 2.0). With increasing concentrations from control to medium, desflurane and isoflurane significantly decreased Hb-O2 affinity by shifting the ODC to the right (p = 0.016 and p < 0.001) but sevoflurane showed no effects. When further increasing concentrations from medium to high, all three inhaled anesthetics shifted the ODC back to the left (p < 0.001). Comparing only controls to high concentrations, a significant increase in Hb-O2 affinity for desflurane (p = 0.005) and sevoflurane (p < 0.001) was detected. Our study shows a varying effect at different doses of inhaled anesthetics on Hb-O2 affinity. While the underlying mechanisms remain unclear, these results show an effect which needs to be further investigated to determine if patients undergoing anesthesia may potentially benefit or get disadvantage from this slightly increased (e.g. impaired pulmonary oxygen uptake), or decreased Hb-O2 affinity (e.g. arterial vascular disease). Trial registration: This study is registered with clinicaltrials.gov (NCT04612270). |
| first_indexed | 2024-04-11T22:38:15Z |
| format | Article |
| id | doaj.art-053822f692db4f019ebfcbcecd7f450c |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T22:38:15Z |
| publishDate | 2022-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-053822f692db4f019ebfcbcecd7f450c2022-12-22T03:59:06ZengNature PortfolioScientific Reports2045-23222022-08-011211710.1038/s41598-022-17789-6The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samplesMarco Ronzani0Simon Woyke1Norbert Mair2Hannes Gatterer3Herbert Oberacher4David Plunser5Thomas Haller6Mathias Ströhle7Christopher Rugg8Department of Anesthesiology and Critical Care Medicine, Medical University of InnsbruckDepartment of Anesthesiology and Critical Care Medicine, Medical University of InnsbruckInstitute of Physiology, Medical University of InnsbruckInstitute of Mountain Emergency Medicine, Eurac ResearchInstitute of Legal Medicine and Core Facility Metabolomics, Medical University of InnsbruckInstitute of Legal Medicine and Core Facility Metabolomics, Medical University of InnsbruckInstitute of Physiology, Medical University of InnsbruckDepartment of Anesthesiology and Critical Care Medicine, Medical University of InnsbruckDepartment of Anesthesiology and Critical Care Medicine, Medical University of InnsbruckAbstract Desflurane, isoflurane and sevoflurane, three halogenated ethers, are commonly used inhaled anesthetics, both in the operating room and in the intensive care unit (ICU). The potency and dosage of these drugs is expressed by the MAC value (minimum alveolar concentration). Their interaction with hemoglobin and its affinity for oxygen, best described by the oxygen dissociation curve (ODC), has already been investigated, with conflicting results. Altered by many factors, the ODC can be shifted to the left or to the right, therefore increasing or decreasing hemoglobin oxygen (Hb-O2) affinity. In venous blood samples of 22 healthy participants (11 female, 11 male) ODC were measured with a high-throughput method in vitro. Blood samples were either exposed to control or to three different concentrations of desflurane, isoflurane or sevoflurane prior to and during measurements (low, medium and high corresponding to MAC 0.5, MAC 1.0 and MAC 2.0). With increasing concentrations from control to medium, desflurane and isoflurane significantly decreased Hb-O2 affinity by shifting the ODC to the right (p = 0.016 and p < 0.001) but sevoflurane showed no effects. When further increasing concentrations from medium to high, all three inhaled anesthetics shifted the ODC back to the left (p < 0.001). Comparing only controls to high concentrations, a significant increase in Hb-O2 affinity for desflurane (p = 0.005) and sevoflurane (p < 0.001) was detected. Our study shows a varying effect at different doses of inhaled anesthetics on Hb-O2 affinity. While the underlying mechanisms remain unclear, these results show an effect which needs to be further investigated to determine if patients undergoing anesthesia may potentially benefit or get disadvantage from this slightly increased (e.g. impaired pulmonary oxygen uptake), or decreased Hb-O2 affinity (e.g. arterial vascular disease). Trial registration: This study is registered with clinicaltrials.gov (NCT04612270).https://doi.org/10.1038/s41598-022-17789-6 |
| spellingShingle | Marco Ronzani Simon Woyke Norbert Mair Hannes Gatterer Herbert Oberacher David Plunser Thomas Haller Mathias Ströhle Christopher Rugg The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples Scientific Reports |
| title | The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples |
| title_full | The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples |
| title_fullStr | The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples |
| title_full_unstemmed | The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples |
| title_short | The effect of desflurane, isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples |
| title_sort | effect of desflurane isoflurane and sevoflurane on the hemoglobin oxygen dissociation curve in human blood samples |
| url | https://doi.org/10.1038/s41598-022-17789-6 |
| work_keys_str_mv | AT marcoronzani theeffectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT simonwoyke theeffectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT norbertmair theeffectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT hannesgatterer theeffectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT herbertoberacher theeffectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT davidplunser theeffectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT thomashaller theeffectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT mathiasstrohle theeffectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT christopherrugg theeffectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT marcoronzani effectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT simonwoyke effectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT norbertmair effectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT hannesgatterer effectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT herbertoberacher effectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT davidplunser effectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT thomashaller effectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT mathiasstrohle effectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples AT christopherrugg effectofdesfluraneisofluraneandsevofluraneonthehemoglobinoxygendissociationcurveinhumanbloodsamples |