Propofol concentration in exhaled air and arterial plasma in mechanically ventilated patients undergoing cardiac surgery

Großherr, M.; Hengstenberg, Andreas; Meier, T.; Dibbelt, L.; Igl, Bernd‐Wolfgang; Ziegler, Andreas; Schmucker, P.; Gehring, Hartmut

doi:10.1093/bja/aep053

Cited by 54 publications

(33 citation statements)

References 12 publications

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“…Among these, Takita et al and Harrison et al accomplished the on-line measurement of propofol in patient's exhaled air by proton transfer reaction mass spectrometry (PTR-MS) [2,3]. In addition, methods such as selected ion flow tube mass spectrometry (SIFT-MS) [4], ionmolecule reaction mass spectrometry (IMR-MS) [5] and gas chromatography mass spectrometry (GC-MS) [6] also have been applied to measure the propofol in exhaled air. However, the instruments involved were expensive and bulky, hence they were not suitable for routine clinical use.…”

Section: Introductionmentioning

confidence: 99%

On-line measurement of propofol using membrane inlet ion mobility spectrometer

Zhou

Wang

Cang

et al. 2012

Talanta

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Section: Introductionmentioning

confidence: 99%

On-line measurement of propofol using membrane inlet ion mobility spectrometer

Zhou

Wang

Cang

et al. 2012

Talanta

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“…However, there is currently no method of doing so. In contrast, propofol concentration in exhaled breath can be detected and measured during anesthesia by various techniques [1][2][3][4][5][6][7][8]. These techniques range from discontinuous techniques like thermal desorption gas chromatography-mass spectrometry (analytical time hours to days) [2,9] to fast discontinuous methods like solid-phase microextraction coupled with gas chromatography mass spectrometry or ion mobility spectrometry coupled to a multicapillary column for pre-separation (analytical time within minutes) [10,11].…”

Section: Introductionmentioning

confidence: 99%

Time course of expiratory propofol after bolus injection as measured by ion molecule reaction mass spectrometry

Hornuß

Wiepcke

Praun³

et al. 2012

Anal Bioanal Chem

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Propofol in exhaled breath can be detected and monitored in real time by ion molecule reaction mass spectrometry (IMR-MS). In addition, propofol concentration in exhaled breath is tightly correlated with propofol concentration in plasma. Therefore, real-time monitoring of expiratory propofol could be useful for titrating intravenous anesthesia, but only if concentration changes in plasma can be determined in exhaled breath without significant delay. To evaluate the utility of IMR-MS during non-steady-state conditions, we measured the time course of both expiratory propofol concentration and the processed electroencephalography (EEG) as a surrogate outcome for propofol effect after an IV bolus induction of propofol. Twenty-one patients scheduled for routine surgery were observed after a bolus of 2.5 mg kg(-1) propofol for induction of anesthesia. Expiratory propofol was measured using IMR-MS and the cerebral propofol effect was estimated using the bispectral index (BIS). Primary endpoints were time to detection of expiratory propofol and time to onset of propofol's effect on BIS, and the secondary endpoint was time to peak effect (highest expiratory propofol or lowest BIS). Expiratory propofol and changes in BIS were first detected at 43 ± 21 and 49 ± 11 s after bolus injection, respectively (P = 0.29). Peak propofol concentrations (9.2 ± 2.4 parts-per-billion) and lowest BIS values (23 ± 4) were reached after 208 ± 57 and 219 ± 62 s, respectively (P = 0.57). Expiratory propofol concentrations measured by IMR-MS have similar times to detection and peak concentrations compared with propofol effect as measured by the processed EEG (BIS). This suggests that expiratory propofol concentrations may be useful for titrating intravenous anesthesia.

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“…Typically, the required propofol concentration for the maintenance of anesthesia was from 1 to 10 μg/ml. 16 After the infusion of propofol by TCI, continuous monitoring of propofol concentration in expiratory by VSAWSA began simultaneously. The propofol concentration in expiratory was measured every approximately 90 s. The whole process of the experiment lasted for 30 to 60 min when the change of the propofol concentration became smooth.…”

Section: Comparing On-line Vsawsa Detection Of Propofol With Targetcomentioning

confidence: 99%

“…This technique can be used to non-invasively monitor the propofol concentration of a patient during surgery. Based on the correlation between the blood propofol concentration and the expiratory concentration, 16,17 the VSAWSA can be used as a reference to monitor anesthesia.…”

Section: Introductionmentioning

confidence: 99%

A Non-invasive Monitoring of Propofol Concentration in Blood by a Virtual Surface Acoustic Wave Sensor Array

et al. 2017

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Propofol (2,6-diisopropylphenol) is widely used in total intravenous anesthesia. An unknown drug concentration in blood always leads to some side effects in patients with propofol injection. However, the drug concentration in the blood is hard to be continuously measured since invasive sampling causes a loss of blood at each measurement. Here, we introduced a virtual surface acoustic wave sensor array (VSAWSA) to non-invasively detect the propofol concentration in blood through exhaled gases. Calibration was conducted by a parallel test using gas chromatography and mass spectrometry (GC-MS) with solid-phase micro-extraction (SPME) for preconcentration. The limit of detection of VSAWSA reached 0.15 nmol/L for propofol. Six cases of clinical trials was conducted to compare the exhaled propofol concentrations to the plasma concentrations controlled by target-controlled infusion (TCI). The calibration by GC-MS ensured the feasibility, reliability, and accuracy of the VSAWSA (R = 0.9904, p <0.001). The clinical monitoring data by VSAWSA showed an excellent consistency with TCI.

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Propofol concentration in exhaled air and arterial plasma in mechanically ventilated patients undergoing cardiac surgery

Abstract: Propofol can be measured in exhaled gas from the beginning until the end of propofol anaesthesia. The different time courses of c(P)PL and c(P)G have to be considered when interpreting c(P)G.

Cited by 54 publications

References 12 publications

On-line measurement of propofol using membrane inlet ion mobility spectrometer

On-line measurement of propofol using membrane inlet ion mobility spectrometer

Time course of expiratory propofol after bolus injection as measured by ion molecule reaction mass spectrometry

A Non-invasive Monitoring of Propofol Concentration in Blood by a Virtual Surface Acoustic Wave Sensor Array

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