High risk of intraoperative awareness during cardiopulmonary bypass with isoflurane administration via diffusion membrane oxygenators

Perfusion. 2002 May;17(3):175-8. doi: 10.1191/0267659102pf566oa.

Abstract

In cardiac surgery with the aid of extracorporeal circulation (ECC), inhalation anaesthetics can be administered via the oxygenator. Until the recent advent of a new type of diffusion membrane oxygenator, we routinely added the inhalation agent, isoflurane, to the gas flow of a microporous capillary membrane-type oxygenator. Applying this procedure to the diffusion-type oxygenators, the depth of anaesthesia appeared to be affected, which manifested itself through unusually high intraoperative perfusion pressures. This observation led to a prospective randomized study comprising 60 patients and two models of a microporous capillary membrane oxygenator, as well as two models of a diffusion membrane oxygenator. Simultaneous isoflurane concentration measurements at both the gas inlet and outlet ports of the oxygenators showed that, whereas in the microporous capillary-type oxygenators the isoflurane administered was reduced by about 50% during the passage of gas through the device, there was only a minimal transfer of isoflurane in the diffusion-type membrane oxygenators.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Anesthetics, Inhalation / administration & dosage*
  • Awareness*
  • Cardiopulmonary Bypass*
  • Diffusion
  • Extracorporeal Membrane Oxygenation / adverse effects*
  • Extracorporeal Membrane Oxygenation / instrumentation
  • Humans
  • Intraoperative Period
  • Isoflurane / administration & dosage*
  • Oxygenators, Membrane / adverse effects*
  • Prospective Studies
  • Risk Factors

Substances

  • Anesthetics, Inhalation
  • Isoflurane