Mets B, Reich N T, Mellas N, Beck J, Park S
Departments of Anesthesiology and Perfusion, Columbia University, New York, NY, USA.
J Cardiothorac Vasc Anesth. 2001 Apr;15(2):179-82. doi: 10.1053/jcan.2001.21945.
To describe the washin and washout of desflurane when first administered during cardiopulmonary bypass (CPB) for cardiac surgery.
A single-arm prospective study.
University-affiliated hospital operating room.
Ten adult patients presenting for cardiac surgery.
Consenting patients presenting for cardiac surgery received anesthesia with midazolam and fentanyl. Patients were cooled to 32 degrees C on CPB, then desflurane 6% was administered and blood samples drawn repeatedly from the arterial and venous bypass cannulae as well as from the membrane oxygenator inlet and exhaust from 2 to 32 minutes of desflurane administration. Just before rewarming, final (maximum) washin samples were taken. On rewarming, desflurane was discontinued, and blood and gas samples were taken 2 to 24 minutes thereafter.
CPB time was 116 +/- 10 minutes, and ischemic time was 81 +/- 6 minutes. Mean pump flow was 4.49 +/- 0.03 L/min, and mean arterial pressure was 70.1 +/- 1 mmHg during the study period. Arterial washin of desflurane was initially rapid; arterial concentrations reached 50% of administered concentrations within 4 minutes, but then slowed, reaching 68% of inspired concentrations at 32 minutes (desflurane concentration 4.0% +/- 0.3%). Arterial washout of desflurane was more rapid; arterial concentrations fell to 18% of the maximum concentration reached within 4 minutes, and only 8% of the maximum arterial concentration was present in blood 20 minutes later.
Desflurane showed rapid initial washin and washout on CPB when administration was started at 32 degrees C and stopped at time of rewarming.
描述在心脏手术体外循环（CPB）期间首次给予地氟醚时的吸入和清除情况。
单臂前瞻性研究。
大学附属医院手术室。
十名接受心脏手术的成年患者。
同意接受心脏手术的患者接受咪达唑仑和芬太尼麻醉。患者在CPB期间被冷却至32摄氏度，然后给予6%的地氟醚，并在给予地氟醚2至32分钟期间，从动脉和静脉旁路插管以及膜式氧合器的入口和出口反复采集血样。在复温前，采集最终（最大）吸入样本。复温时，停止使用地氟醚，并在其后2至24分钟采集血液和气体样本。
CPB时间为116±10分钟，缺血时间为81±6分钟。研究期间平均泵流量为4.49±0.03升/分钟，平均动脉压为70.1±1毫米汞柱。地氟醚的动脉吸入最初很快；动脉浓度在4分钟内达到给药浓度的50%，但随后减慢，在32分钟时达到吸入浓度的68%（地氟醚浓度4.0%±0.3%）。地氟醚的动脉清除更快；动脉浓度在4分钟内降至所达到的最大浓度的18%，20分钟后血液中仅存在最大动脉浓度的8%。
当在32摄氏度开始给药并在复温时停止给药时，地氟醚在CPB上显示出快速的初始吸入和清除。
