Effects of propofol vs methohexital on neutrophil function and immune status in critically ill patients.

Journal of Anesthesia
Egbert HuettemannSamir G Sakka

Abstract

Patients with severe brain injury often require long-term sedation and have a high incidence of nosocomial infections, causing an increased mortality rate. However, whether anesthetic drugs might contribute to immunosuppressive effects remains unclear. In this prospective study, we investigated the effects of propofol (4-6 mg x kg(-1) x h(-1)) and methohexital (1-3 mg x kg(-1) x h(-1)) on neutrophil leukocyte function and immune status in 21 patients with brain injury who either received propofol (n = 12; 9 male, 3 female; mean age, 51 +/- 15 years) or methohexital (n = 9; 8 male, 1 female; mean age, 48 +/- 17 years) after admission to the intensive care unit (ICU). Both sedatives were administered over 7 days and individual dosage was adapted according to clinical requirements. Neutrophil leukocyte function was assessed as phagocytosis and respiratory oxidative burst activity. Furthermore, leukocyte subpopulations, and surface markers of lymphocytes and monocytes (CD3; CD4; CD45RO; CD4/CD45RO; CD25; CD4 and CD25; CD54; CD69; CD14/HLA-DR; CD8; CD3/HLA-DR; CD4 : CD8 ratio) were assessed. Blood samples were drawn on ICU admission, and on days 3, 7, and 14. Patients' demographics were compared by Wilcoxon test and laboratory resul...Continue Reading

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Citations

Apr 22, 2011·Der Anaesthesist·P HilbertR Stuttmann
Aug 8, 2008·Journal of Anesthesia·Shin Kurosawa, Masato Kato
May 29, 2009·British Journal of Anaesthesia·N R Webster, H F Galley
Nov 15, 2011·Anesthesiology Clinics·Robert D SandersMervyn Maze
Jul 6, 2010·Biochimica Et Biophysica Acta·Jing TangMiaoning Gu
Jul 7, 2009·Critical Care Clinics·Robert D SandersMervyn Maze
Aug 23, 2017·World Journal of Critical Care Medicine·Luciana Boavista Barros HeilPatricia Rieken Macedo Rocco
Aug 5, 2018·Journal of Cellular Biochemistry·Yunes PanahiAmirhossein Sahebkar

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.