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Larger tidal volume increases sevoflurane uptake in blood: a randomized clinical study

Enekvist, Bruno LU ; Bodelsson, Mikael LU ; Walther Sturesson, Louise LU and Johansson, Arne LU (2010) In Acta Anaesthesiologica Scandinavica 54(9). p.1111-1116
Abstract
Background The rate of uptake of volatile anesthetics is dependent on alveolar concentration and ventilation, blood solubility and cardiac output. We wanted to determine whether increased tidal volume (V-T), with unchanged end-tidal carbon dioxide partial pressure (PETCO2), could affect the arterial concentration of sevoflurane. Methods Prospective, randomized, clinical study. ASA physical status 2 and II patients scheduled for elective surgery of the lower abdomen were randomly assigned to one of the two groups with 10 patients in each: one group with normal V-T (NVT) and one group with increased V-T (IVT) achieved by increasing the inspired plateau pressure 0.04 cmH(2)O/kg above the initial plateau pressure. A corrugated tube added extra... (More)
Background The rate of uptake of volatile anesthetics is dependent on alveolar concentration and ventilation, blood solubility and cardiac output. We wanted to determine whether increased tidal volume (V-T), with unchanged end-tidal carbon dioxide partial pressure (PETCO2), could affect the arterial concentration of sevoflurane. Methods Prospective, randomized, clinical study. ASA physical status 2 and II patients scheduled for elective surgery of the lower abdomen were randomly assigned to one of the two groups with 10 patients in each: one group with normal V-T (NVT) and one group with increased V-T (IVT) achieved by increasing the inspired plateau pressure 0.04 cmH(2)O/kg above the initial plateau pressure. A corrugated tube added extra apparatus dead space to maintain PETCO2 at 4.5 kPa. The respiratory rate was set at 15 min-1, and sevoflurane was delivered to the fresh gas by a vaporizer set at 3%. Arterial sevoflurane tensions (P(a)sevo), F(i)sevo, P(ET)sevo, PETCO2, PaCO2, V-T and airway pressure were measured. Results The two groups of patients were similar with regard to gender, age, weight, height and body mass index. The mean P(ET)sevo did not differ between the groups. Throughout the observation time, arterial sevoflurane tension (mean +/- SE) was significantly higher in the IVT group compared with the NVT group, e.g. 1.9 +/- 0.23 vs. 1.6 +/- 0.25 kPa after 60 min of anesthesia (P < 0.05). Conclusion Ventilation with larger tidal volumes with isocapnia maintained with added dead-space volume increases the tension of sevoflurane in arterial blood. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
54
issue
9
pages
1111 - 1116
publisher
Wiley-Blackwell
external identifiers
  • wos:000281631400010
  • scopus:77956417525
ISSN
0001-5172
DOI
10.1111/j.1399-6576.2010.02291.x
language
English
LU publication?
yes
id
912af69d-0112-4a52-ad58-07a92cf3e008 (old id 1697923)
date added to LUP
2010-10-22 12:00:00
date last changed
2018-05-29 12:23:26
@article{912af69d-0112-4a52-ad58-07a92cf3e008,
  abstract     = {Background The rate of uptake of volatile anesthetics is dependent on alveolar concentration and ventilation, blood solubility and cardiac output. We wanted to determine whether increased tidal volume (V-T), with unchanged end-tidal carbon dioxide partial pressure (PETCO2), could affect the arterial concentration of sevoflurane. Methods Prospective, randomized, clinical study. ASA physical status 2 and II patients scheduled for elective surgery of the lower abdomen were randomly assigned to one of the two groups with 10 patients in each: one group with normal V-T (NVT) and one group with increased V-T (IVT) achieved by increasing the inspired plateau pressure 0.04 cmH(2)O/kg above the initial plateau pressure. A corrugated tube added extra apparatus dead space to maintain PETCO2 at 4.5 kPa. The respiratory rate was set at 15 min-1, and sevoflurane was delivered to the fresh gas by a vaporizer set at 3%. Arterial sevoflurane tensions (P(a)sevo), F(i)sevo, P(ET)sevo, PETCO2, PaCO2, V-T and airway pressure were measured. Results The two groups of patients were similar with regard to gender, age, weight, height and body mass index. The mean P(ET)sevo did not differ between the groups. Throughout the observation time, arterial sevoflurane tension (mean +/- SE) was significantly higher in the IVT group compared with the NVT group, e.g. 1.9 +/- 0.23 vs. 1.6 +/- 0.25 kPa after 60 min of anesthesia (P &lt; 0.05). Conclusion Ventilation with larger tidal volumes with isocapnia maintained with added dead-space volume increases the tension of sevoflurane in arterial blood.},
  author       = {Enekvist, Bruno and Bodelsson, Mikael and Walther Sturesson, Louise and Johansson, Arne},
  issn         = {0001-5172},
  language     = {eng},
  number       = {9},
  pages        = {1111--1116},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Larger tidal volume increases sevoflurane uptake in blood: a randomized clinical study},
  url          = {http://dx.doi.org/10.1111/j.1399-6576.2010.02291.x},
  volume       = {54},
  year         = {2010},
}