Administration of drugs during cardiopulmonary bypass

Abstract

Summary This study was conducted to determine the efficiency of delivery of drugs injected as holuses by the common

Effects of propofol on mean arterial pressure and systemic vascular resistance during cardiopulmonary bypass

“…Rouby et al (16) have shown, in patients with artificial hearts, a significantly greater decrease in SVR with propofol than with thiopental, falling to nearly 50% of the basal value 5 min after administration of the drug. Likewise, in a study similar to ours but with no control group, Baraka et al ( 1 7) showed a decrease in the MAP following propofol administration during CPB which is comparable in coronary and valvular patients, and which cannot be Table 2 Hemodynamic values prior to (basal) and I , 3,5,10,15,20 and 30 min after administration of 0.9% saline solution (control, n = 10) or 2 mg. kg-' propofol (n = 10) during cardiopulmonary bypass. attributed to decreases in the venous return.…”

“…This reduction in the afterload of the left ventricle, with the consequent decrease in the ventricular work that it produces (5, 6), partially counteracts the negative inotropic effects of the drug that have been demonstrated in both animals (19) and humans (10). During CPB, the most reliable route for administration of drugs is through the pump oxygenator venous reservoir (20). However, the oleic nature of propofol, due to its solvent, impeded its rapid and homogeneous mixture with the oxygenator blood in this study and explains the appearance of a "supernatant" for some time after its administration.…”

“…The anesthesiologist (who was the same in all 20 cases) and the perfusionist conducted the bypass according to routine, and were not informed as to which solution was being administered. Prior (basal) and I , 3,5,10,15,20 and 30 min afterwards, MAP (mmHg) and SVR (dyn s cm-') were determined according to the formula:…”

Abordagem PK-PD do propofol na revascularização do miocárdio para estudo da influência da circulação extracorpórea na ligação às proteínas plasmáticas e no efeito hipnótico

“…Estes podem se ligar competitivamente às proteínas plasmáticas e promover o deslocamento do fármaco do sítio de ligação, aumentando temporariamente a sua concentração plasmática. Além disso, a administração da protamina reverte a anticoagulação da heparina; portanto a protamina restringe o efeito desse antitrombótico na extensão da ligação do propofol à albumina plasmática (KAMATH et al, 1980;METS, 2000;WOOD, 1979).…”

“…Em Após a retirada das cânulas vasculares, procede-se à reversão da anticoagulação promovida pela heparina com a protamina (KAMATH et al, 1980;METS, 2000).…”