Related Experiment Video

Updated: May 13, 2026

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
09:36

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Published on: September 24, 2020

Effect of propofol and sevoflurane on acid-base balance during pediatric heart catheterization

A Fudickar1, K Smigaj, R Ensenauer

  • 1Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany. fudickar@anesthesie.uni-kiel.de

Minerva Anestesiologica
|March 21, 2013
PubMed

Insights

Propofol anesthesia during pediatric heart catheterization significantly altered base excess and pH, unlike sevoflurane. This suggests sevoflurane may be a safer alternative, reducing risks associated with Propofol Infusion Syndrome (PRIS).

Area of Science:

  • Anesthesiology
  • Pediatric Cardiology
  • Critical Care Medicine

Background:

  • Propofol is a common anesthetic for pediatric heart catheterization.
  • Propofol infusion syndrome (PRIS) is a rare but severe complication characterized by bradycardia and asystolia.
  • Metabolic acidosis is an early indicator of PRIS.

Purpose of the Study:

  • To compare the effects of propofol and sevoflurane on acid-base balance and lactate levels during pediatric heart catheterization.
  • To evaluate the potential risk of PRIS by monitoring key metabolic indicators.

Main Methods:

  • A prospective randomized study involving 42 children undergoing heart catheterization.
  • Children were anesthetized with either propofol (N.=22) or sevoflurane (N.=20).
  • Blood gas analysis measured base excess, pH, and lactate at baseline, during, and post-procedure.

Main Results:

  • Propofol significantly decreased base excess (P=0.0004) and pH (P=0.0008) compared to baseline.
  • The incidence of base excess < 5.0 increased significantly in the propofol group (P=0.016).
  • Lactate levels decreased in both groups, with no significant difference between anesthetics.

Conclusions:

  • Propofol, but not sevoflurane, significantly impacted base excess and pH during pediatric heart catheterization.
  • Sevoflurane appears to be a safer anesthetic choice, potentially reducing the risk of PRIS in this patient population.
Abstract

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Disorders of Acid-Base Balance01:29

Disorders of Acid-Base Balance

The human body maintains a precise pH range of arterial blood between 7.35 and 7.45. Deviations result in either acidosis (pH < 7.35) or alkalosis (pH > 7.45). These conditions are further classified as respiratory or metabolic disorders based on their underlying cause.
Respiratory Acidosis and Alkalosis
Respiratory acidosis occurs due to an increase in the partial pressure of carbon dioxide PCO2 in the blood. It often arises from shallow breathing or impaired gas exchange caused by...
Diagnosing Acidosis and Alkalosis01:24

Diagnosing Acidosis and Alkalosis

Diagnosing acid-base imbalances involves systematically analyzing arterial blood samples, focusing on three key measurements: pH, bicarbonate (HCO3−) concentration, and carbon dioxide partial pressure (PCO2). This analysis follows a four-step process that helps identify the imbalance's underlying cause and nature.
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
Next, the PCO2  and HCO3−  values are examined to...
Acid-Base Balance01:25

Acid-Base Balance

The human body maintains a narrow pH range regulated through acid-base balance. This balance is crucial as changes in the hydrogen ion concentration can disrupt cell membrane stability, alter protein structures, and change enzyme activities. The normal pH of arterial blood is 7.4, venous blood and interstitial fluid is 7.35, and intracellular fluid averages 7.0.
When the pH of arterial blood rises above 7.45, it results in a condition called alkalosis. Conversely, a drop below 7.35 leads to...
Respiratory Regulation of Acid-Base Balance01:18

Respiratory Regulation of Acid-Base Balance

Respiratory compensation is a vital physiological process that stabilizes blood plasma pH by regulating the partial pressure of carbon dioxide (PCO2), a key determinant of pH levels. Most carbon dioxide in the blood dissolves and converts into carbonic acid (H2CO3). It dissociates into hydrogen ions (H+) and bicarbonate ions (HCO3⁻). There is also an inverse relationship between PCO2​​ and pH.
When carbon dioxide levels increase in the blood, more H+ and HCO3⁻ are produced, leading to a...
Bronsted-Lowry Acids and Bases02:58

Bronsted-Lowry Acids and Bases

The acid-base reaction class has been studied for quite some time. In 1680, Robert Boyle reported traits of acid solutions that included their ability to dissolve many substances, to change the colors of certain natural dyes, and to lose these traits after coming in contact with alkali (base) solutions. In the eighteenth century, it was recognized that acids have a sour taste, react with limestone to liberate a gaseous substance (now known to be CO2), and interact with alkalis to form neutral...