Title: | Sevoflurane-enriched blood cardioplegia: the intramyocardial delivery of a volatile anesthetic |
Author(s): | van der Baan A; Kortekaas KA; van Es E; Meier S; Klautz RJ; Engbers FH; |
Address: | "Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands a.van_der_baan@lumc.nl. Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands. Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands" |
ISSN/ISBN: | 1477-111X (Electronic) 0267-6591 (Linking) |
Abstract: | "Myocardial ischemia/reperfusion injury is a major problem in cardiac surgery, characterized by an enhanced inflammatory response postoperatively. Sevoflurane has anti-inflammatory effects and may attenuate this injury. This study describes a novel approach to using sevoflurane as a local anti-inflammatory drug and not as an anesthetic. Therefore, a pediatric oxygenator with a sevoflurane vaporizer was integrated into the blood cardioplegia system of an adult bypass system. In addition, a gas blender was implemented to regulate pO2 and pCO2 concentrations in the cardioplegia. This proof-of-principle study was tested in vivo and shows that it is feasible to deliver sevoflurane locally while regulating O2 and CO2 concentrations. Moreover, this set-up enables one to use only the specific cardioprotective features of sevoflurane. Inflammatory responses were attenuated, both locally (i.e. the heart) as well as systemically through intramyocardial delivery of sevoflurane" |
Keywords: | "Aged Anesthetics/*administration & dosage Cardioplegic Solutions/*administration & dosage Female Heart Arrest, Induced/adverse effects/*methods Humans Male Methyl Ethers/*administration & dosage Middle Aged Myocardial Reperfusion Injury/*prevention & cont;" |
Notes: | "Medlinevan der Baan, A Kortekaas, K A van Es, E Meier, S Klautz, R J M Engbers, F H M eng Clinical Study Research Support, Non-U.S. Gov't England 2014/08/03 Perfusion. 2015 May; 30(4):295-301. doi: 10.1177/0267659114545666. Epub 2014 Aug 1" |