Document Detail

In vivo uptake and elimination of isoflurane by different membrane oxygenators during cardiopulmonary bypass.
MedLine Citation:
PMID:  12131114     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Volatile anesthetics are frequently used during cardiopulmonary bypass (CPB) to maintain anesthesia. Uptake and elimination of the volatile agent are dependent on the composition of the oxygenator. This study was designed to evaluate whether the in vivo uptake and elimination of isoflurane differs between microporous membrane oxygenators containing a conventional polypropylene (PPL) membrane and oxygenators with a new poly-(4-methyl-1-pentene) (PMP) membrane measuring isoflurane concentrations in blood. METHODS: Twenty-four patients undergoing elective coronary bypass surgery with the aid of CPB were randomly allocated to one of four groups, using either one of two different PPL-membrane oxygenators for CPB or one of two different PMP-membrane oxygenators. During hypothermic CPB, 1% isoflurane in an oxygen-air mixture was added to the oxygenator gas inflow line (gas flow, 3 l/min) for 15 min. Isoflurane concentration was measured in blood and in exhaust gas at the outflow port of the oxygenator. Between-group comparisons were performed for the area under the curve (AUC) during uptake and elimination of the isoflurane blood concentrations, the maximum isoflurane blood concentration (C(max)), and the exhausted isoflurane concentration (F(E)). RESULTS: The uptake of isoflurane, expressed as AUC of isoflurane blood concentration and a function of F(E), was significantly reduced in PMP oxygenators compared to PPL oxygenators (P < 0.01). C(max) was between 8.5 and 13 times lower in the PMP-membrane oxygenator groups compared to the conventional PPL-membrane oxygenator groups (P < 0.01). CONCLUSIONS: The uptake of isoflurane into blood via PMP oxygenators during CPB is severely limited. This should be taken into consideration in cases using such devices.
Christoph Wiesenack; Gunther Wiesner; Cornelius Keyl; Michael Gruber; Alois Philipp; Markus Ritzka; Christopher Prasser; Kai Taeger
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  97     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-19     Completed Date:  2002-08-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  133-8     Citation Subset:  AIM; IM    
Department of Anesthesiology, University Hospital, Regensburg, Germany. wiesenack@rkananw1/ngate/
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MeSH Terms
Aged, 80 and over
Anesthetics, Inhalation / blood*
Cardiopulmonary Bypass*
Isoflurane / blood*
Middle Aged
Oxygenators, Membrane*
Reg. No./Substance:
0/Anesthetics, Inhalation; 26675-46-7/Isoflurane

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