Rapid Infusion of Hydroxyethyl Starch 70/0.5 but not Acetate Ringer’s Solution Decreases the Plasma Concentration of Propofol during Target-controlled Infusion

Abstract

Background Rapid fluid infusion resulting in increased hepatic blood flow may decrease the propofol plasma concentration (Cp) because propofol is a high hepatic extraction drug. The authors investigated the effects of rapid colloid and crystalloid infusions on the propofol Cp during target-controlled infusion. Methods Thirty-six patients were randomly assigned to 1 of 3 interventions (12 patients per group). At least 30 min after the start of propofol infusion, patients received either a 6% hydroxyethyl starch (HES) solution at 24 ml·kg−1·h−1 or acetated Ringer’s solution at 24 or 2 ml·kg−1·h−1 during the first 20 min. In all groups, acetated Ringer’s solution was infused at 2 ml·kg−1·h−1 during the next 20 min. The propofol Cp was measured every 2.5 min as the primary outcome. Cardiac output, blood volume, and indocyanine green disappearance rate were determined using a pulse dye densitogram analyzer before and after the start of fluid administration. Effective hepatic blood flow was calculated as the blood volume multiplied by the indocyanine green disappearance rate. Results The rapid HES infusion significantly decreased the propofol Cp by 22 to 37%, compared to the Cp at 0 min, whereas the rapid or maintenance infusion of acetate Ringer’s solution did not decrease the propofol Cp. Rapid HES infusion, but not acetate Ringer’s solution infusion, increased the effective hepatic blood flow. Conclusions Rapid HES infusion increased the effective hepatic blood flow, resulting in a decreased propofol Cp during target-controlled infusion. Rapid HES infusion should be used cautiously as it may decrease the depth of anesthesia.

Liposome-based multifunctional nanoplatform as effective therapeutics for the treatment of retinoblastoma

“…Till now, various NIR agents, including indocyanine green (ICG) 14 , 15 , 16 , gold nanoparticles 17 , 18 , 19 , carbon nanodot 20 , or graphene oxide 21 , 22 , 23 have been widely employed for evaluating cardiovascular and hepatic function and ophthalmic circulation. ICG is the only NIR agent approved by the FDA 24 , 25 and can effectively absorb NIR laser and convert it into heat or produce singlet oxygen for PTT and photodynamic therapy (PDT) 26 , 27 . Furthermore, ICG can also be used for detecting real-time fluorescence (FL) and photoacoustic (PA) imaging of tumor tissue 28 , which can provide precise and personalized interventions for cancer therapy.…”