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Isoflurane in Contrast to Propofol Promotes Fluid Extravasation during Cardiopulmonary Bypass in Pigs
- Source :
- Anesthesiology. 119:861-870
- Publication Year :
- 2013
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2013.
-
Abstract
- Background: A highly positive intraoperative fluid balance should be prevented as it negatively impacts patient outcome. Analysis of volume-kinetics has identified an increase in interstitial fluid volume after crystalloid fluid loading during isoflurane anesthesia. Isoflurane has also been associated with postoperative hypoxemia and may be associated with an increase in alveolar epithelial permeability, edema formation, and hindered oxygen exchange. In this article, the authors compare fluid extravasation rates before and during cardiopulmonary bypass (CPB) with isoflurane- versus propofol-based anesthesia. Methods: Fourteen pigs underwent 2 h of tepid CPB with propofol (P-group; n = 7) or isoflurane anesthesia (I-group; n = 7). Fluid requirements, plasma volume, colloid osmotic pressures in plasma and interstitial fluid, hematocrit levels, and total tissue water content were recorded, and fluid extravasation rates calculated. Results: Fluid extravasation rates increased in the I-group from the pre-CPB level of 0.27 (0.13) to 0.92 (0.36) ml·kg−1·min−1, but remained essentially unchanged in the P-group with significant between-group differences during CPB (pb = 0.002). The results are supported by corresponding changes in interstitial colloid osmotic pressure and total tissue water content. Conclusions: During CPB, isoflurane, in contrast to propofol, significantly contributes to a general increase in fluid shifts from the intravascular to the interstitial space with edema formation and a possible negative impact on postoperative organ function.
- Subjects :
- Male
Oncotic pressure
Swine
law.invention
Interstitial space
Osmotic Pressure
Interstitial fluid
law
Suidae
Cardiopulmonary bypass
Animals
Edema
Medicine
Plasma Volume
Propofol
Cardiopulmonary Bypass
Isoflurane
biology
business.industry
biology.organism_classification
Extravasation
Ringer's Solution
Disease Models, Animal
Anesthesiology and Pain Medicine
Hematocrit
Anesthesia
Anesthetics, Inhalation
Fluid Therapy
Female
Isotonic Solutions
business
Anesthetics, Intravenous
medicine.drug
Subjects
Details
- ISSN :
- 00033022
- Volume :
- 119
- Database :
- OpenAIRE
- Journal :
- Anesthesiology
- Accession number :
- edsair.doi.dedup.....794ee9d34c16abad4bb7166c0f7a6ec7
- Full Text :
- https://doi.org/10.1097/aln.0b013e31829ab018