A Comparison of the Arterial Blood Concentration of Isoflurane During Cardiopulmonary Bypass Between 2 Polypropylene Oxygenators

Abstract

Objective: The primary objective was to compare arterial blood concentration of isoflurane during cardiopulmonary bypass (CPB) between 2 polypropylene oxygenators of different designs. Secondary objectives were to compare levels of Bispectral Index Score (BIS) during CPB between the 2 oxygenators and to examine the relationships between oxygenator exhaust and arterial blood concentrations of isoflurane and BIS.

Design: Single, blinded, randomized control trial.

Setting: Teaching hospital.

Participants: Twenty-five patients undergoing cardiac surgery with CPB.

Interventions: Subjects were randomly assigned (1:1) to Inspire 8F (Sorin) or Affinity Fusion (Medtronic) oxygenators.

Measurements and main results: The mean arterial blood concentration in the Inspire 8F (Sorin) group was 59 (standard deviation [SD] 23) µg/mL, compared with 53 (SD 17) µg/mL in the Affinity Fusion (Medtronic) group with a nonsignificant mean difference of 6 (95% confidence interval = -11, 22) µg/mL (t[23] = 0.676, p = 0.50). No significant difference in BIS was found between the groups (p = 0.896). Moderate and strong, negative correlations respectively, were found between arterial and oxygenator exhaust correlations and BIS (r = -0.472, p < 0.05; r = -0.812, p < 0.001). A strong, positive correlation was found between arterial and exhaust isoflurane concentration (r = 0.810, p < 0.0005).

Conclusions: No significant difference in arterial blood concentration of isoflurane or BIS was found between the Inspire 8F (Sorin) and Affinity Fusion (Medtronic) oxygenators. A significant positive correlation was found between arterial blood and oxygenator exhaust concentrations of isoflurane, as well as significant negative correlations between both arterial and oxygenator exhaust concentrations of isoflurane and BIS.

Keywords: anesthesia; cardiopulmonary bypass; heart surgery; isoflurane; oxygenator.