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Oral carbohydrate solution cause an inflammatory response when aspirated into the lungs in mice

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Abstract

Purpose

Many studies have been published on the beneficial effects of oral carbohydrate solutions (OCS) administered prior to surgery. However, the risk of pulmonary aspiration cannot be excluded in all patients undergoing anesthesia. But, there are few studies on the safety of OCS at lung aspiration.

Methods

Experiments were conducted with mice (Nine- to ten-week-old male BALB/c mice weighted 23–26 g). Lung aspiration was performed by intratracheal administration of OCS and its major constituents, fructose and maltodextrin. Bronchoalveolar lavage fluid (BALF) was collected 3 and 24 h after lung aspiration. The level of Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and macrophage inflammatory protein-2 (MIP-2) were measured in BALF. The total white blood cell, neutrophil counts, wet to dry ratio and histological examination were performed in BALF and lung tissue, respectively, at 24 h after aspiration.

Results

The OCS increased the level of TNF-α, IL-6 and MIP-2 at 3 h and the neutrophil count at 24 h in BALFs, compared to a phosphate-buffered saline (PBS) group. The increase in IL-6 level induced by OCS was maintained for 24 h. The OCS also increased the number of white blood cells and the percentage of neutrophils in BALFs. Compared to fructose, maltodextrin significantly increased the production of MIP-2 in BALFs. OCS and maltodextrin also increased neutrophil recruitment in lung tissue.

Conclusion

Aspiration of OCS may cause inflammation of the lungs. The preoperative use of OCS may require caution under specific clinical conditions, such as patients at risk of lung aspiration.

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Acknowledgments

This study was supported by a grant (Number: CRI 16012-1) from Chonnam National University Hospital Research Institute of Clinical Medicine.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Chonnam National University Hospital, 160, Baekseo-ro, Dong-gu, Gwangju, 501-746, Korea

    Joungmin Kim, Minji Kim, Hong-Beom Bae & Jeong-Il Choi

  2. Department of Forensic Medicine, Chonnam National University Medical School, Hwasun, Korea

    Hyung-Seok Kim

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  1. Joungmin Kim
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Correspondence to Hong-Beom Bae or Jeong-Il Choi.

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Kim, J., Kim, HS., Kim, M. et al. Oral carbohydrate solution cause an inflammatory response when aspirated into the lungs in mice. J Anesth 35, 86–92 (2021). https://doi.org/10.1007/s00540-020-02873-w

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  • DOI: https://doi.org/10.1007/s00540-020-02873-w

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