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General anesthesia and exhaled breath hydrogen peroxide
W C Wilson1, J F Swetland, J L Benumof
1Department of Anesthesiology, University of California, San Diego Medical Center 92103-8770.
Anesthesiology
|May 1, 1992
Summary
General anesthesia did not elevate hydrogen peroxide (H2O2) levels in exhaled breath. However, patients with adult respiratory distress syndrome (ARDS) showed significantly increased H2O2, indicating its role in lung injury.
Area of Science:
- Pulmonary Medicine
- Anesthesiology
- Free Radical Research
Background:
- General anesthesia is associated with pulmonary dysfunction.
- Free radical formation, specifically hydrogen peroxide (H2O2), is a potential mechanism for this impairment.
Purpose of the Study:
- To investigate the role of free radical formation in pulmonary dysfunction during general anesthesia.
- To measure exhaled breath hydrogen peroxide (H2O2) concentrations in different patient groups.
Main Methods:
- Collected exhaled breath condensate from 27 patients in three groups: healthy, cardiopulmonary bypass (CPB), and adult respiratory distress syndrome (ARDS).
- Assayed H2O2 concentrations using a spectrophotometric method.
- Collected samples before and after anesthesia (intravenous and inhalational) in healthy patients, before and after CPB, and upon meeting ARDS criteria.
Main Results:
- No significant H2O2 was detected in healthy patients undergoing general anesthesia.
- H2O2 levels were near zero in CPB patients, except for one case with lupus anticoagulant.
- ARDS patients exhibited significantly elevated mean exhaled breath H2O2 concentrations (0.55 +/- 0.08 microM).
Conclusions:
- General anesthesia, including common intravenous and inhalational agents, does not appear to increase exhaled hydrogen peroxide.
- Elevated H2O2 in exhaled breath is associated with adult respiratory distress syndrome (ARDS), suggesting a role in lung injury pathophysiology.