Ischemia–Reperfusion-Induced Unmeasured Anion Generation and Glycocalyx Shedding: Sevoflurane versus Propofol Anesthesia

ABSTRACTIntroduction: Vascular leakage after ischemia–reperfusion (IR) is largely attributed to the destruction of the endothelial barrier and its associated negatively charged glycocalyx. In vitro, sevoflurane attenuates these changes. Therefore, we compared sevoflurane with propofol with regard to the protection of the glycocalyx and the release of negatively charged substances in vivo. Methods: After surgical preparation under midazolam–fentanyl, nine pigs each received either propofol or sevoflurane. Ischemia of 90 min was induced by a balloon catheter in the thoracic aorta. After 120 min of reperfusion, the anesthetics were changed back to midazolam–fentanyl. Five animals, each without aortic occlusion, served as time controls. Blood electrolyte parameters were measured, from which the strong ion gap (SIG) was calculated. Serum heparan sulfate concentrations and immunohistology served as a marker of glycocalyx destruction. Results: Immediately after reperfusion, SIG increased significantly only in th...