Detecting Alveolar Epithelial Injury following Volatile Anesthetics by 99mTc DTPA Radioaerosol Inhalation Lung Scan

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Abstract
Background: Many volatile anesthetics have long been thought to affect alveolar epithelial permeability. Objective: The purpose of this study was to examine the acute effects of volatile anesthetics on the permeability of the alveolocapillary barrier to 99mTc DTPA. Methods: Twenty-seven patients (24 females, 3 males, age 29–73 years) undergoing operation were enrolled in this study and grouped according to the type of anesthesia received. Group 1 patients were administered 1% halothane. Group 2 patients were given 1.5% isoflurane. Intravenous anesthesia without volatile anesthetics were used for group 3 patients. Before and after anesthesia, 99mTc DTPA radioaerosol inhalation lung scans were performed to detect alveolar epithelial injury due to volatile anesthetics. The negative slope of the regression line was designated as the 99mTc DTPA pulmonary clearance rate and was expressed in terms of percentage decrease in radioactivity per minute. Results: In group 1, the 99mTc DTPA clearance rates were 1.26 ± 0.34 and 1.29 ± 0.38 before and after anesthesia, respectively. The difference was not significant (p > 0.05). In group 2, the rates were 0.76 ± 0.20 and 1.10 ± 0.37, before and after anesthesia, respectively. The difference was significant (p < 0.05). In group 3, the clearance rates were 1.07 ± 0.38 and 1.21 ± 0.48, before and after anesthesia, respectively. The difference was not significant. Conclusions: Following isoflurane administration, the more rapid pulmonary clearance of 99mTc DTPA indicates that isoflurane increases the permeability of the alveolo-capillary barrier.

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