1982
DOI: 10.2165/00003088-198207030-00004
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Effect of Cardiopulmonary Bypass on the Pharmacokinetics of Drugs

Abstract: The cardiopulmonary bypass apparatus must temporarily substitute for the cardiac and pulmonary function of the patient undergoing heart surgery. In order to meet the metabolic needs of the patient and the technical demands of the surgeon, within the limits of engineering technology, a number of major alterations are made in normal physiology. The patient is typically cooled to 27 degrees C and perfused with a non-pulsatile flow of blood which has been diluted with saline to a haematocrit in the mid-20s. Blood … Show more

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Cited by 124 publications
(81 citation statements)
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References 71 publications
(21 reference statements)
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“…Total body clearance remained unchanged Plasma diclofenac levels (ng/ml) for both groups of patients in spite of a 30% reduction in hepatic blood flow as reported previously (4,5). The present data showed wide interindividual variation for both groups when expressed as median: 3.50 CPB vs 5.03 ml min -1 kg -1 control, P = 0.13 (Table 1), or as range of variation IC95%: 2.91-4.43 ml min -1 kg -1 (CPB) and 3.32-6.03 ml min -1 kg -1 (control) (P>0.05).…”
Section: Introductionsupporting
confidence: 80%
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“…Total body clearance remained unchanged Plasma diclofenac levels (ng/ml) for both groups of patients in spite of a 30% reduction in hepatic blood flow as reported previously (4,5). The present data showed wide interindividual variation for both groups when expressed as median: 3.50 CPB vs 5.03 ml min -1 kg -1 control, P = 0.13 (Table 1), or as range of variation IC95%: 2.91-4.43 ml min -1 kg -1 (CPB) and 3.32-6.03 ml min -1 kg -1 (control) (P>0.05).…”
Section: Introductionsupporting
confidence: 80%
“…During the postoperative period of cardiac surgery with cardiopulmonary bypass, there is a 30% reduction of hepatic blood flow accompanied by changes in the metabolism of diclofenac (4,5). The aim of the present study was to measure the pharmacokinetics and pharmacodynamics of diclofenac on the basis of plasma protein binding, during the postoperative period in surgical patients submitted or not to cardiopulmonary bypass.…”
Section: Introductionmentioning
confidence: 98%
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“…The first sample was taken before administration of pipecuronium, the others were collected 2, 4,6,8,10,15,20,30,45,60,90,120,180,240,360 and 480 min after the end of injection. Additional blood samples were taken five minutes after the start of extracorporeal circulation and immediately at the end of cardiopulmonary bypass.…”
Section: Procedures Of the Kinetic Studymentioning
confidence: 99%
“…Haemodilution decreases drug binding to plasma proteins, and the resulting increase of the unbound drug fraction tends to increase the Vdss. 24 The large volumes of fluids infused could have contributed to the large Vd.,..,. of alfentanil in our patients.…”
Section: Discussionmentioning
confidence: 99%