In vitro uptake and elimination of isoflurane by different membrane oxygenators

Hickey, Stephen; Gaylor, J.D.S.

doi:10.1016/s1053-0770(96)80096-6

Cited by 21 publications

(16 citation statements)

References 9 publications

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“…Notwithstanding the variances in delivery of isoflurane to the oxygenator, uptake by the patient can be affected by the design of oxygenator as they have different gas transfer characteristics. 25 As we used the same design of oxygenator in all patients, this will not have been a source of variance in our findings but limits extrapolation of our findings to different designs of oxygenators. However, subsequent research by our group found no difference in arterial blood concentrations of isoflurane between the one used in the present study and a different design of polypropylene oxygenator.…”

Section: Discussionmentioning

confidence: 95%

The depth of anaesthesia associated with the administration of isoflurane 2.5% during cardiopulmonary bypass

et al. 2019

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Background: Administering isoflurane 2.5% into the oxygenator during cardiopulmonary bypass results in no patient movement. However, doing so may result in an excessive depth of anaesthesia particularly, when hypothermia is induced. Bispectral index and arterial blood and oxygenator exhaust concentrations of volatile anaesthetics should be related to depth of anaesthesia. The primary aim of this study was to measure the depth of anaesthesia using bispectral index, resulting from administering isoflurane 2.5% into the oxygenator during cardiopulmonary bypass, and secondary aims were to examine the relationships between blood and oxygenator exhaust isoflurane concentrations and bispectral index. Methods: Arterial and mixed-venous blood samples were aspirated at three time points during cardiopulmonary bypass and measured for isoflurane concentration using mass spectrometry. Simultaneously, oxygenator exhaust isoflurane concentration, nasopharyngeal temperature and bispectral index were recorded. Results: When averaged across the three time points, all patients had a bispectral index score below 40 (binomial test, p < 0.001). There were no significant correlations between bispectral index score and arterial or mixed-venous blood isoflurane concentrations (r = –0.082, p = 0.715; r = –0.036, p = 0.874) and oxygenator exhaust gas concentration of isoflurane (r = –0.369, p = 0.091). Conclusion: When 2.5% isoflurane was administered into the sweep gas supply to the oxygenator during cardiopulmonary bypass, all patients experienced a bispectral index score less than 40 and no significant relationship was found between either arterial or mixed-venous blood or oxygenator exhaust concentrations of isoflurane and bispectral index.

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Section: Discussionmentioning

confidence: 95%

The depth of anaesthesia associated with the administration of isoflurane 2.5% during cardiopulmonary bypass

et al. 2019

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“…Another factor that might account for the differences in findings between the studies was the type of oxygenator that was used as an in-vitro study by Hickey and colleagues has found that different designs have different transfer rates for anaesthetic gases to exchange into the blood circulation. 19 As no studies have been undertaken in humans to compare the gas transfer of isoflurane between different oxygenators, the importance of this in the relationship between arterial and oxygenator exhaust isoflurane concentration is unknown. We are currently undertaking a study (NCT03146949) to determine whether there are any differences in blood concentrations of isoflurane between different makes of oxygenators.…”

Section: Discussionmentioning

confidence: 99%

Assessing the depth of isoflurane anaesthesia during cardiopulmonary bypass

Alston

Just

et al. 2017

Perfusion

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“…The permeability of the different oxygenators to volatile anesthetics have been the subject of numerous studies (17–20). In these studies, the volatile anesthetic was supplied during a defined time interval using the fresh gas supply to the oxygenators.…”

Section: Discussionmentioning

confidence: 99%