Evidence map›Paper›PMID 40637441›Full record

SynthesisCritical care explorations2025

Effect of Inhaled Volatile and IV Anesthetics on Biological Markers of Inflammation in Adult ICU and Thoracic Surgical Patients: A Systematic Review and Meta-Analysis.

Soroush Rouhani, Sanchit Gupta, Hira Raheel, Aggie Duan Gao, Ciara Hanley, Xingshan Cao, Alla Iansavitchene, Brian H Cuthbertson, Marat Slessarev, Ewan C Goligher and 5 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Critical care explorations, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Soroush RouhaniDepartment of Medicine, London Health Sciences Centre, London, ON, Canada.
Sanchit GuptaDepartment of Anesthesiology and Pain Management, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Hira RaheelDepartment of Medicine, London Health Sciences Centre, London, ON, Canada.
Aggie Duan GaoDepartment of Medicine, London Health Sciences Centre, London, ON, Canada.
Ciara HanleyDepartment of Anaesthesia and Critical Care, University Hospital Galway, Galway, Ireland.
Xingshan CaoSunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Alla IansavitcheneLondon Health Sciences Centre, Corporate Academics, London, ON, Canada.
Brian H CuthbertsonDepartment of Anesthesiology and Pain Management, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Marat SlessarevDepartment of Medicine, London Health Sciences Centre, London, ON, Canada.
Ewan C GoligherInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Aleksandra LeligdowiczDepartment of Medicine, London Health Sciences Centre, London, ON, Canada.
Douglas D FraserSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Beverley A OrserDepartment of Anesthesiology and Pain Management, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Angela JerathDepartment of Anesthesiology and Pain Management, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
SAVE-ICU Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesInhaled anesthetics may reduce alveolar and systemic inflammation in surgical and critically ill patients. This study aimed to perform a systematic review and meta-analysis comparing the effect of inhaled volatile and IV anesthetics on alveolar and plasma cytokines in patients with surgical or medical acute lung injury. DATA SOURCES: Medline, Embase, and Cochrane CENTRAL databases from 2000 to July 2021. STUDY SELECTION: Randomized control trials, prospective, and retrospective observational studies comparing inhaled volatile to IV anesthetics in ventilated adult patients with acute lung injury from lung resection or critical illness. DATA EXTRACTION: A systematic review and meta-analysis was performed. Primary outcome was alveolar inflammatory cytokines levels that were meta-analyzed using a random effects model. Secondary outcomes were plasma inflammatory cytokine levels, mortality, pulmonary complications, and duration of hospital and ICU stay. The quality of studies was assessed using the Cochrane Risk of Bias tool for randomized control trials and the Cochrane Risk Of Bias In Non-randomized Studies of Interventions tool for retrospective cohort studies. DATA SYNTHESIS: From 2522 screened studies, 28 (27 thoracic surgery and 1 ICU, n = 4175) were included. Meta-analysis of patients undergoing lung resection demonstrated lower levels of alveolar tumor necrosis factor-alpha (TNF-α) (standard mean difference 1.04; 95% CI, 0.32-1.77; p < 0.01; I2 82%) and interleukin (IL)-6 (0.64; 95% CI, 0.52-0.75; I2 0%; p < 0.01) at 1-2 hours in the inhaled anesthesia group, with no difference in other cytokines at various time points. The single ICU study demonstrated lower plasma TNF-α and IL-6 and alveolar TNF-α, IL-6, and IL-8 at 48 hours in patients sedated with sevoflurane compared with midazolam. Clinical outcomes were infrequently reported.

conclusionsLimited evidence suggests that inhaled anesthesia may reduce proinflammatory cytokines TNF-α and IL-6 during lung resection and critical illness. Further studies are needed to clarify its effects on biological markers and clinical outcomes.

Indexed as

Anesthetics, InhalationAnesthetics, IntravenousInflammationThoracic Surgical ProceduresAcute Lung InjuryAdultBiomarkersCytokinesHumansIntensive Care UnitsAnesthetics, InhalationAnesthetics, IntravenousBiomarkersCytokinescritical carecytokineinflammationlung injurylung resectionone-lung ventilationthoracic surgeryvolatile anesthetics

Identifiers

PMID40637441
PMCPMC12440536

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.