Assessing transient pulmonary injury induced by volatile anesthetics by increased lung uptake of technetium-99m hexamethylpropylene amine oxime.

Volatile anesthetics such as halothane and isoflurane have long been thought to affect pulmonary function. The purpose of this study was to examine whether volatile anesthetics (halothane and isoflurane) can induce pulmonary vascular endothelium damage. Before surgery, 1 h after surgery, and 1 week after surgery, the degree of pulmonary vascular endothelium damage was represented as increased lung/liver uptake ratios (L/L ratio) and measured on technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) lung scan in 3 groups of the patients. Group 1 included 20 patients undergoing surgery and receiving volatile anesthesia with 1% halothane. Group 2 included 20 patients undergoing surgery and receiving volatile anesthesia with 1.5% isoflurane. Group 3 included 20 patients undergoing surgery with intravenous anesthesia drugs. No significant change of L/L ratio was found from before surgery, 1 h after surgery, to 1 week after surgery in group 3 patients. In groups 1 and 2 patients, significantly transient increased L/L ratio was found 1 h after surgery. We conclude that volatile anesthesia (halothane and isoflurane) can induce transient pulmonary vascular endothelium damage, represented as transiently increased L/L ratios on Tc-99m HMPAO lung scan.