Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Perioperative Management System, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2022 Feb;84(1):163-168. doi: 10.18999/nagjms.84.1.163.
Volatile anesthetics (VAs) protect myocardial cells during cardiovascular surgeries, including cardiopulmonary bypass (CPB). In CPB, blood is gradually transferred from the body to a CPB unit until the target cardiac index is achieved, following which human lung (HL) ventilation is stopped. This pilot study aimed to evaluate changes in the blood sevoflurane concentrations 5 min after the start of CPB when its delivery to the oxygenator began after HL ventilation with sevoflurane was completed. Six patients were recruited and participated in this study. For each patient, the equilibrated blood sample, collected 20 min after starting the delivery of 1.7% sevoflurane (HL group), and another blood sample, collected 5 min after starting the CPB, were analyzed using gas chromatography equipped with a flame ionization detector. The mean (± standard deviation) sevoflurane concentrations in the HL and 5 min after starting CPB groups were 58.6 ± 4.7 and 14.5 ± 5.0 μg/ml, respectively ( < 0.01). In conclusion, the equilibrated blood sevoflurane concentrations showed a rapid decrease when switching from sevoflurane ventilation for the HL to CPB unless it was introduced to the oxygenator until completion of the switch.
挥发性麻醉剂（VAs）在心血管手术中保护心肌细胞，包括心肺旁路（CPB）。在 CPB 中，血液逐渐从体内转移到 CPB 装置，直到达到目标心指数，然后停止人的肺（HL）通气。这项初步研究旨在评估 CPB 开始后 5 分钟时血液中七氟醚浓度的变化，此时 HL 通气完成后开始向氧气输送七氟醚。招募了 6 名患者参加了这项研究。对于每个患者，分析了在开始输送 1.7%七氟醚后 20 分钟（HL 组）采集的平衡血液样本和在 CPB 开始后 5 分钟采集的另一个血液样本，使用配备火焰离子化检测器的气相色谱法。HL 组和 CPB 开始后 5 分钟组的七氟醚浓度平均值（±标准差）分别为 58.6 ± 4.7 和 14.5 ± 5.0 μg/ml（<0.01）。总之，从 HL 通气切换到 CPB 时，除非在切换完成之前将其引入氧气输送器，否则平衡血液中的七氟醚浓度会迅速下降。
