scholarly journals Pancuronium Requirements during Hypothermic Cardiopulmonary Bypass in Man

1983 ◽  
Vol 11 (3) ◽  
pp. 216-219 ◽  
Author(s):  
Malcolm E. Futter ◽  
David G. Whalley ◽  
J. Earl Wynands ◽  
David R. Bevan
Keyword(s):  
Cardiopulmonary Bypass ◽  
Neuromuscular Junction ◽  
Infusion Rate ◽  
Bolus Dose ◽  
Principal Agent ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Train Of Four ◽  
The Mean

Eight patients were studied to determine the changes in pancuronium requirements during hypothermic cardiopulmonary bypass. They were anaesthetised with fentanyl as the principal agent, ventilated with oxygen and the neuromuscular junction was monitored using train-of-four stimulation. After a bolus dose of pancuronium an infusion was used to maintain the first twitch of the train-of-four at 5-15 per cent of control. Before bypass the mean pancuronium infusion rate was 0.52 (SD 0.16) μg/kg/min. There was a small, brief increase in requirement with the initiation of bypass to 0.62 (SD 0.38) μg/kg/min, which was followed by a decrease of more than 80 per cent during hypothermia to 0.08 (SD 0.03) μg/kg/min. Rewarming was associated with a rapid increase in requirement to 0.64 (SD 0.17) μg/kg/min, which decreased to 0.33 (SD 0.23) μg/kg/min when normothermia was re-established.

scholarly journals Use of a New Syringe Pump (Springfusor®) for Muscle Relaxant Infusion

1993 ◽  
Vol 21 (4) ◽  
pp. 444-446 ◽  
Author(s):  
C. C. P. Eagle ◽  
D. F. Capes
Keyword(s):  
Muscle Relaxant ◽  
Infusion Rate ◽  
Bolus Dose ◽  
Muscle Relaxants ◽  
Syringe Pump ◽  
Background Infusion ◽  
Continuous Background ◽  
Nominal Rate ◽  
The Mean ◽  
Initial Bolus

A new spring-driven syringe pump (Springfusor 10®, Go Medical Industries, Subiaco, W.A.) was evaluated for infusion of muscle relaxants in 50 surgical cases. After an initial bolus dose, atracurium was given at a rate of 25 to 37.5 mg/hour and vecuronium at a rate of 4 to 6 mg/hour. The mean infusion rate was found to be 4% above the nominal rate of 5 ml/hour and the accuracy in all cases was within ± 20%. The Springfusor was found to be rugged, cheap and easy to use. It lacks dose flexibility but is suitable for continuous background infusion of muscle relaxants during surgery.

Lower Perfusion Pressure during Hypothermic Cardiopulmonary Bypass Is Associated with Decreased Cerebral Blood Flow and Impaired Memory Performance 6 Months Postoperatively

2010 ◽  
Vol 13 (1) ◽  
pp. 7 ◽  
Author(s):  
Adolfo Paolin ◽  
Paolo Michielon ◽  
Michele Betetto ◽  
Giuseppe Sartori ◽  
Carlo Valfr� ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cardiopulmonary Bypass ◽  
Perfusion Pressure ◽  
Memory Performance ◽  
Artery Bypass ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Memory Assessment ◽  
The Mean ◽  
Cognitive Memory

Objectives: We undertook to determine the influence of perfusion pressure during hypothermic cardiopulmonary bypass (CPB) on cerebral blood flow (CBF) and cognitive memory outcome at 6 months postoperatively.Methods: Nineteen patients who underwent hypothermic nonpulsatile CPB for elective coronary artery bypass (CAB) surgery were evaluated by 133Xe measurement of the CBF and by the Incidental Memory Assessment for evaluating cognitive memory (IMTscore), both at baseline before the operation (T1) and again at 5 to 6 months postoperatively (T2).Results: Overall, the mean CBF fell significantly from 39 5 mL(100 g)-1min-1 at T1 to 33 3 mL(100 g)-1min-1 at T2 (P < .001). The decrease in CBF from T1 to T2 (CBF2-1) correlated with a significant reduction in the IMTscore from T1 to T2 (IMTscore2-1) (P < .001) and with a mean arterial pressure during CPB (MAPCPB) of

A computerized system forthe study of oxygen uptake and haemodynamics during cardiopulmonary bypass

Perfusion ◽  
1989 ◽  
Vol 4 (3) ◽  
pp. 197-203 ◽  
Author(s):  
RP Alston ◽  
RA Rennie ◽  
F. Toal ◽  
Gnc Kenny
Keyword(s):  
Cardiopulmonary Bypass ◽  
Oxygen Uptake ◽  
Confidence Intervals ◽  
Temperature Control ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Arterial Ph ◽  
Record Data ◽  
The Mean ◽  
Computerized System

A computerized system which incorporated haemodynamic, temperature and arterial pH (pHa) monitoring was developed to record data and to improve temperature and pHa control during hypothermic cardiopulmonary bypass (CPB). The system was evaluated in the course of a study of haemodynamics and metabolism during CPB. It was planned to have three 10 minute periods of study in 24 patients, during which time arterial and nasopharyngeal temperatures would be maintained between 27° and 29°C and pHa between 7.38 and 7.42. Repeated recordings of haemodynamic variables, temperature and pHa were made during each period. Only 59 of a possible 72 periods were obtained due to shortage of time at stable hypothermia. The mean number of total readings was 73.5 (70.1, 77.0) and the mean number of acceptable readings was 71.2 (67.3, 75.1). Good nasopharyngeal temperature control was achieved, with all the 95% confidence intervals of the means falling within the prescribed limits. Control of arterial temperature was less good as there were five periods in which the 95% confidence intervals of the means fell outwith the prescribed range. Poor pHa control was achieved since there were 16 periods in which the 95% confidence intervals of the mean were outside the preset range. The system functioned well in recording data and resulted in good temperature control, but poor pHa control.

Outcomes of the Extracardiac Fontan Procedure Using Cardiopulmonary Bypass: Early Results

2014 ◽  
Vol 17 (3) ◽  
pp. 173 ◽  
Author(s):  
Murat Ugurlucan ◽  
Eylem Yayla Tuncer ◽  
Fusun Guzelmeric ◽  
Eylul Kafali ◽  
Omer Ali Sayin ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Arterial Oxygen Saturation ◽  
Vena Cava ◽  
Arterial Oxygen ◽  
Shunt Operation ◽  
Early Results ◽  
The Mean ◽  
Extracardiac Fontan

<p><strong>Background</strong>: Although the avoidance of cardiopulmonary bypass during the Fontan procedure has potential advantages, using cardiopulmonary bypass during this procedure has no adverse effects in terms of morbidity and mortality rates. In this study, we assessed the postoperative outcomes of our first 9 patients who have undergone extracardiac Fontan operation by the same surgeon using cardiopulmonary bypass.</p><p><strong>Methods</strong>: Between September 2011 and April 2013,  9 consecutive patients (3 males and 6 females) underwent extra-cardiac Fontan operation. All operations were performed under cardiopulmonary bypass at normothermia by the same surgeon.  The age of patients ranged between 4 and 17 (9.8 ± 4.2) years. Previous operations performed on these patients were modified Blalock-Taussig shunt procedure in 2 patients, bidirectional cavopulmonary shunt operation in 6 patients, and pulmonary arterial banding in 1 patient. Except 2 patients who required intracardiac intervention, cross-clamping was not applied. In all patients, the extracardiac Fontan procedure was carried out by interposing an appropriately sized tube graft between the infe-rior vena cava and right pulmonary artery.</p><p><strong>Results</strong>: The mean intraoperative Fontan pressure and transpulmonary gradient were 12.3 ± 2.5 and 6.9 ± 2.2 mm Hg, respectively. Intraoperative fenestration was not required. There was no mortality and 7 patients were discharged with-out complications. Complications included persistent pleural effusion in 1 patient and a transient neurological event in 1 patient. All patients were weaned off mechanical ventila-tion within 24 hours. The mean arterial oxygen saturation increased from 76.1% ± 5.3% to 93.5% ± 2.2%. All patients were in sinus rhythm postoperatively. Five patients required blood and blood-product transfusions. The mean intensive care unit and hospital stay periods were 2.9 ± 1.7 and 8.2 ±  1.9 days, respectively.</p><p><strong>Conclusions</strong>: The extracardiac Fontan operation per-formed using cardiopulmonary bypass provides satisfactory results in short-term follow-up and is associated with favor-able postoperative hemodynamics and morbidity rates.</p>

The oxygen- and acid-base status during hypothermic cardiopulmonary bypass

1988 ◽  
Vol 48 ◽  
pp. 63-71 ◽  
Author(s):  
Ivar Gøthgen ◽  
Ole Siggaard-Andersen ◽  
Jens Rasmussen ◽  
Peter Wimberley ◽  
Niels Fogh. Andersen
Keyword(s):  
Cardiopulmonary Bypass ◽  
Acid Base ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Acid Base Status

Elimination of three doses of gentamicin over three consecutive days using a polyacrylonitrile-derived filter: An in vitro assessment

2021 ◽  
pp. 039139882110322
Author(s):  
Frédéric J Baud ◽  
Vanessa Seif ◽  
Pascal Houzé ◽  
Jean-Herlé Raphalen ◽  
Benoît Pilmis ◽  
...  
Keyword(s):  
Life Span ◽  
Bolus Dose ◽  
Central Compartment ◽  
Daily Session ◽  
Progressive Decrease ◽  
Time Dependency ◽  
Study Results ◽  
In Vitro Assessment ◽  
The Mean

Introduction: Adsorption of gentamicin in a polyacrylonitrile filter was previously evidenced in a session lasting 6 h using the NeckEpur model. We extended the study over three consecutive days to mimic the 72-h life span of a filter. Methods: Prismaflex® monitor and ST150® filter were used in the continuous diafiltration (CDF) mode at a 2.5 L/h flowrate. The daily session started with a 6-h session of CDF. Thereafter, the 5-L central compartment was changed using a bag free of gentamicin to assess gentamicin release over the following 18 h. Experiments were repeated on Day 2 and stopped at the end of the 6-h session of CDF on Day 3. The experiment was performed in duplicate. Results: At a 2.5 L/h diafiltration flowrate, the mean daily clearances of gentamicin were 5.5, 4.0, and 3.3 L/h, respectively. The mean diafiltration and adsorption ratios in the daily elimination of gentamicin were 32/68%, 58/42%, and 88/12%, respectively. During days 1 and 2, the mean amount of gentamicin released from the ST150® filter were 14 and 34 mg, respectively. Conclusion: The pharmacokinetics of gentamicin over 3 days is strongly altered by adsorption in the same filter with a progressive decrease of elimination by adsorption, suggesting saturation of the filter. One limitation of our study results from the mode of administration using a bolus dose instead of an infusion over 30 min. Adsorption adds a clearance to those of diafiltration. The time-dependency of gentamicin clearance precludes using a constant dosage regimen over the filter’s life span.

Neuromuscular blockade effects of cisatracurium in 11 cats undergoing ophthalmological surgery anaesthetised with isoflurane

2021 ◽  
pp. 1098612X2110218
Author(s):  
Anne-Sophie Van Wijnsberghe ◽  
Keila K Ida ◽  
Petra Dmitrovic ◽  
Alexandru Tutunaru ◽  
Charlotte Sandersen
Keyword(s):  
Neuromuscular Blockade ◽  
Case Series ◽  
Neuromuscular Function ◽  
Duration Of Action ◽  
Cardiovascular Side Effects ◽  
Train Of Four ◽  
Physical Classification ◽  
The Mean ◽  
American Society ◽  
American Society Of Anesthesiologists

Case series summary This case series describes the neuromuscular blockade (NMB) following 0.15 mg/kg intravenous (IV) cisatracurium administration in 11 cats undergoing ophthalmological surgery and anaesthetised with isoflurane. Anaesthetic records were analysed retrospectively. Neuromuscular function was assessed by a calibrated train-of-four (TOF) monitor. Cats were 73 ± 53 months old, weighed 4 ± 1 kg and were of American Society of Anesthesiologists’ physical classification 2. Duration of anaesthesia and surgery were 144 ± 27 and 94 ± 24 mins, respectively. The lowest TOF count was zero in four cats, four in six cats and for one cat the TOF ratio never decreased below 31%. The time of onset was between 1 and 6 mins after the administration of cisatracurium and the mean duration of action was 20.4 ± 10.1 mins. Relevance and novel information Cisatracurium at a dose of 0.15 mg/kg IV did not consistently induce a TOF count of zero in all cats. The dose used in these cats did not produce any remarkable cardiovascular side effects. Although the NMB was not complete, the dose given was sufficient to produce central eyeball position, which was the goal of the ophthalmic surgeries.

Sign in / Sign up

Export Citation Format

Share Document