Katarina Ruscic, PhD, MD
Member of the Faculty of Anesthesia
Massachusetts General Hospital
Lecturer on Anaesthesia
Harvard Medical School
Dr. Ruscic’s Research
The Effects of Anesthetics on Lymphatic Vessel Contractility
Systemic lymphatic dysfunction is rarely considered in critically ill patients with tissue edema. However, the lymphatics reclaim 8L of plasma to the circulation each day to maintain fluid homeostasis. To do this, lymphatic vessels have spontaneous contractile behavior which can be decreased during inflammation or infection. This study will explore the effects of commonly used anesthetics on lymphatic contractility and the interaction of the sympathetic nervous system (SNS) with these effects. Hypothesis 1: isoflurane and propofol decrease lymphatic pumping while ketamine increases it, Hypothesis 2: these phenomena are due to systemic effects rather than direct effects on lymphatic vasculature, Hypothesis 3: pharmacologic manipulation of SNS-lymphatic vessel signaling will modify the effects of isoflurane, propofol and ketamine on lymphatic pumping.
This study explores novel consequences of anesthetic exposure with critical implications for fluid balance in patients. These effects could be even more profound with prolonged exposure to anesthetics, such as in critical illness.