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Effects of methacholine infusion on desflurane pharmacokinetics in piglets
Alf Kozian1, Moritz Kretzschmar1, James E Baumgardner2
1Department of Anesthesiology and Intensive Care Medicine, Otto-von-Guericke-University Magdeburg, Germany ; Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden.
Abstract:
The data of a corresponding animal experiment demonstrates that nebulized methacholine (MCh) induced severe bronchoconstriction and significant inhomogeneous ventilation and pulmonary perfusion (V̇A/Q̇) distribution in pigs, which is similar to findings in human asthma. The inhalation of MCh induced bronchoconstriction and delayed both uptake and elimination of desflurane (Kretzschmar et al., 2015) [1]. The objective of the present data is to determine V̇A/Q̇ matching by Multiple Inert Gas Elimination Technique (MIGET) in piglets before and during methacholine- (MCh-) induced bronchoconstriction, induced by MCh infusion, and to assess the blood concentration profiles for desflurane (DES) by Micropore Membrane Inlet Mass Spectrometry (MMIMS). Healthy piglets (n=4) under general anesthesia were instrumented with arterial, central venous, and pulmonary artery lines. The airway was secured via median tracheostomy with an endotracheal tube, and animals were mechanically ventilated with intermittent positive pressure ventilation (IPPV) with a FiO2 of 0.4, tidal volume (V T)=10 ml/kg and PEEP of 5cmH2O using an open system. The determination of V.A/Q. was done by MIGET: before desflurane application and at plateau in both healthy state and during MCh infusion. Arterial blood was sampled at 0, 1, 2, 5, 10, 20, and 30 min during wash-in and washout, respectively. Bronchoconstriction was established by MCH infusion aiming at doubling the peak airway pressure, after which wash-in and washout of the anesthetic gas was repeated. Anesthesia gas concentrations were measured by MMIMS. Data were analyzed by ANOVA, paired t-test, and by nonparametric Friedman׳s test and Wilcoxon׳s matched pairs test. We measured airway pressures, pulmonary resistance, and mean paO2 as well as hemodynamic variables in all pigs before desflurane application and at plateau in both healthy state and during methacholine administration by infusion. By MIGET, fractional alveolar ventilation and pulmonary perfusion in relation to the V.A/Q. compartments, data of logSDQ̇ and logSDV̇ (the second moments describing global dispersion, i.e. heterogeneity of distribution) were estimated prior to and after MCh infusion. The uptake and elimination of desflurane was determined by MMIMS.
Insights
Methacholine-induced bronchoconstriction in piglets significantly worsened ventilation-perfusion (V̇A/Q̇) inequality, impacting desflurane uptake and elimination. This animal model mimics human asthma, highlighting V̇A/Q̇ matching changes during airway constriction.
Area of Science:
- Anesthesiology
- Pulmonary Physiology
- Animal Research
Background:
- Nebulized methacholine (MCh) causes bronchoconstriction and ventilation-perfusion (V̇A/Q̇) distribution abnormalities in pigs, similar to human asthma.
- MCh-induced bronchoconstriction is known to delay desflurane (DES) uptake and elimination.
Purpose of the Study:
- To determine V̇A/Q̇ matching using Multiple Inert Gas Elimination Technique (MIGET) in piglets before and during MCh-induced bronchoconstriction.
- To assess blood concentration profiles of desflurane (DES) using Micropore Membrane Inlet Mass Spectrometry (MMIMS) during induced bronchoconstriction.
Main Methods:
- Healthy piglets (n=4) underwent general anesthesia and mechanical ventilation.
- V̇A/Q̇ distribution was measured by MIGET before and during MCh infusion, aiming to double peak airway pressure.
- Desflurane (DES) wash-in and washout were analyzed using MMIMS, with arterial blood sampling at timed intervals.
Main Results:
- MCh infusion induced severe bronchoconstriction, significantly increasing V̇A/Q̇ inequality (logSDQ̇ and logSDV̇).
- Bronchoconstriction altered desflurane uptake and elimination kinetics.
- Hemodynamic variables, airway pressures, pulmonary resistance, and PaO2 were monitored throughout the experiment.
Conclusions:
- MCh-induced bronchoconstriction in piglets leads to significant V̇A/Q̇ mismatching.
- This animal model effectively replicates asthma-like V̇A/Q̇ disturbances.
- The study provides insights into anesthetic gas behavior during bronchoconstriction, relevant for clinical anesthesia in obstructive lung diseases.
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