Blood concentrations of enflurane before, during, and after hypothermic cardiopulmonary bypass

Roger Goucke, L.P. Hackett, Hugh Barrett, Kenneth Ilett

    Research output: Contribution to journal › Article

    6 Citations (Scopus)

    Abstract

    Objective: The purpose of this study was to determine blood concentrations of enflurane delivered via a membrane oxygenator during hypothermic cardiopulmonary bypass (CPB) with changes in the input enflurane concentration and temperature and to characterize the pharmacokinetics of enflurane washout during and after CPB.Design: Blood enflurane concentrations were measured by gas chromatography before, during, and after CPB by using mean delivered enflurane concentrations of 0.5% v/v (group 1, n = 5), 0.8% (group 2, n = 7), and 1% (group 3, n 14).Setting: The investigation was performed in a teaching hospital setting.Participants: Twenty-six patients undergoing cardiac surgery requiring hypothermic CPB.Interventions: Variations in input enflurane concentration in different patients plus blood sampling from the arterial side of the circuit for enflurane assay.Measurements and Main Results: Median (25th and 75th percentiles) pre-CPB blood enflurane concentrations were 48 (25-50) mg/L, 52 (47-56) mg/L, and 115 (90-143) mg/L in groups 1 (0.5% v/v), 2 (0.8% v/v), and 3 (1% v/v), respectively. During hypothermia (28 degrees C) corresponding enflurane concentrations were 44 (31-53) mg/L, 56 (45-62) mg/L, and 145 (109-203) mg/L, respectively. For groups 1 and 2, there were no significant changes in blood enflurane compared with the corresponding pre-CPB value. However, for group 3, cooling resulted in a significant increase (p = 0.006) in blood enflurane. In all groups, enflurane concentrations after rewarming were similar to those in the pre-CPB period.Conclusions: It is concluded that exposure to enflurane concentrations greater than 0.8% during CPB can result in high blood concentrations. (c) 2007 Elsevier Inc. All rights reserved.
    Original languageEnglish
    Pages (from-to)218-223
    JournalJournal of Cardiothoracic and Vascular Anesthesia
    Volume21
    Issue number2
    DOIs
    Publication statusPublished - 2007

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    Enflurane
    Cardiopulmonary Bypass
    Membrane Oxygenators
    Rewarming
    Hypothermia
    Teaching Hospitals
    Gas Chromatography
    Thoracic Surgery

    Cite this

    Goucke, Roger ; Hackett, L.P. ; Barrett, Hugh ; Ilett, Kenneth. / Blood concentrations of enflurane before, during, and after hypothermic cardiopulmonary bypass. In: Journal of Cardiothoracic and Vascular Anesthesia. 2007 ; Vol. 21, No. 2. pp. 218-223.
    @article{9ecebd70e2354dc78669c036c9ca6e3a,
    title = "Blood concentrations of enflurane before, during, and after hypothermic cardiopulmonary bypass",
    abstract = "Objective: The purpose of this study was to determine blood concentrations of enflurane delivered via a membrane oxygenator during hypothermic cardiopulmonary bypass (CPB) with changes in the input enflurane concentration and temperature and to characterize the pharmacokinetics of enflurane washout during and after CPB.Design: Blood enflurane concentrations were measured by gas chromatography before, during, and after CPB by using mean delivered enflurane concentrations of 0.5{\%} v/v (group 1, n = 5), 0.8{\%} (group 2, n = 7), and 1{\%} (group 3, n 14).Setting: The investigation was performed in a teaching hospital setting.Participants: Twenty-six patients undergoing cardiac surgery requiring hypothermic CPB.Interventions: Variations in input enflurane concentration in different patients plus blood sampling from the arterial side of the circuit for enflurane assay.Measurements and Main Results: Median (25th and 75th percentiles) pre-CPB blood enflurane concentrations were 48 (25-50) mg/L, 52 (47-56) mg/L, and 115 (90-143) mg/L in groups 1 (0.5{\%} v/v), 2 (0.8{\%} v/v), and 3 (1{\%} v/v), respectively. During hypothermia (28 degrees C) corresponding enflurane concentrations were 44 (31-53) mg/L, 56 (45-62) mg/L, and 145 (109-203) mg/L, respectively. For groups 1 and 2, there were no significant changes in blood enflurane compared with the corresponding pre-CPB value. However, for group 3, cooling resulted in a significant increase (p = 0.006) in blood enflurane. In all groups, enflurane concentrations after rewarming were similar to those in the pre-CPB period.Conclusions: It is concluded that exposure to enflurane concentrations greater than 0.8{\%} during CPB can result in high blood concentrations. (c) 2007 Elsevier Inc. All rights reserved.",
    author = "Roger Goucke and L.P. Hackett and Hugh Barrett and Kenneth Ilett",
    year = "2007",
    doi = "10.1053/j.jvca.2006.08.009",
    language = "English",
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    pages = "218--223",
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    Goucke, R, Hackett, LP, Barrett, H & Ilett, K 2007, 'Blood concentrations of enflurane before, during, and after hypothermic cardiopulmonary bypass' Journal of Cardiothoracic and Vascular Anesthesia, vol. 21, no. 2, pp. 218-223. https://doi.org/10.1053/j.jvca.2006.08.009

    Blood concentrations of enflurane before, during, and after hypothermic cardiopulmonary bypass. / Goucke, Roger; Hackett, L.P.; Barrett, Hugh; Ilett, Kenneth.

    In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 21, No. 2, 2007, p. 218-223.

    Research output: Contribution to journal › Article

    TY - JOUR

    T1 - Blood concentrations of enflurane before, during, and after hypothermic cardiopulmonary bypass

    AU - Goucke, Roger

    AU - Hackett, L.P.

    AU - Barrett, Hugh

    AU - Ilett, Kenneth

    PY - 2007

    Y1 - 2007

    N2 - Objective: The purpose of this study was to determine blood concentrations of enflurane delivered via a membrane oxygenator during hypothermic cardiopulmonary bypass (CPB) with changes in the input enflurane concentration and temperature and to characterize the pharmacokinetics of enflurane washout during and after CPB.Design: Blood enflurane concentrations were measured by gas chromatography before, during, and after CPB by using mean delivered enflurane concentrations of 0.5% v/v (group 1, n = 5), 0.8% (group 2, n = 7), and 1% (group 3, n 14).Setting: The investigation was performed in a teaching hospital setting.Participants: Twenty-six patients undergoing cardiac surgery requiring hypothermic CPB.Interventions: Variations in input enflurane concentration in different patients plus blood sampling from the arterial side of the circuit for enflurane assay.Measurements and Main Results: Median (25th and 75th percentiles) pre-CPB blood enflurane concentrations were 48 (25-50) mg/L, 52 (47-56) mg/L, and 115 (90-143) mg/L in groups 1 (0.5% v/v), 2 (0.8% v/v), and 3 (1% v/v), respectively. During hypothermia (28 degrees C) corresponding enflurane concentrations were 44 (31-53) mg/L, 56 (45-62) mg/L, and 145 (109-203) mg/L, respectively. For groups 1 and 2, there were no significant changes in blood enflurane compared with the corresponding pre-CPB value. However, for group 3, cooling resulted in a significant increase (p = 0.006) in blood enflurane. In all groups, enflurane concentrations after rewarming were similar to those in the pre-CPB period.Conclusions: It is concluded that exposure to enflurane concentrations greater than 0.8% during CPB can result in high blood concentrations. (c) 2007 Elsevier Inc. All rights reserved.

    AB - Objective: The purpose of this study was to determine blood concentrations of enflurane delivered via a membrane oxygenator during hypothermic cardiopulmonary bypass (CPB) with changes in the input enflurane concentration and temperature and to characterize the pharmacokinetics of enflurane washout during and after CPB.Design: Blood enflurane concentrations were measured by gas chromatography before, during, and after CPB by using mean delivered enflurane concentrations of 0.5% v/v (group 1, n = 5), 0.8% (group 2, n = 7), and 1% (group 3, n 14).Setting: The investigation was performed in a teaching hospital setting.Participants: Twenty-six patients undergoing cardiac surgery requiring hypothermic CPB.Interventions: Variations in input enflurane concentration in different patients plus blood sampling from the arterial side of the circuit for enflurane assay.Measurements and Main Results: Median (25th and 75th percentiles) pre-CPB blood enflurane concentrations were 48 (25-50) mg/L, 52 (47-56) mg/L, and 115 (90-143) mg/L in groups 1 (0.5% v/v), 2 (0.8% v/v), and 3 (1% v/v), respectively. During hypothermia (28 degrees C) corresponding enflurane concentrations were 44 (31-53) mg/L, 56 (45-62) mg/L, and 145 (109-203) mg/L, respectively. For groups 1 and 2, there were no significant changes in blood enflurane compared with the corresponding pre-CPB value. However, for group 3, cooling resulted in a significant increase (p = 0.006) in blood enflurane. In all groups, enflurane concentrations after rewarming were similar to those in the pre-CPB period.Conclusions: It is concluded that exposure to enflurane concentrations greater than 0.8% during CPB can result in high blood concentrations. (c) 2007 Elsevier Inc. All rights reserved.

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    JO - Journal of Cardiothoracic and Vascular Anaesthesia

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    Goucke R, Hackett LP, Barrett H, Ilett K. Blood concentrations of enflurane before, during, and after hypothermic cardiopulmonary bypass. Journal of Cardiothoracic and Vascular Anesthesia. 2007;21(2):218-223. https://doi.org/10.1053/j.jvca.2006.08.009

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