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Propofol sequestration within the extracorporeal circuit

M Hynynen1, E Hammarén, P H Rosenberg

  • 1Department of Anaesthesia, Helsinki University Central Hospital, Finland.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|July 1, 1994
PubMed
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During cardiac anesthesia, propofol is sequestered by the extracorporeal circuit. This sequestration significantly reduces plasma propofol concentration, impacting drug delivery during cardiopulmonary bypass.

Area of Science:

  • Anesthesiology
  • Pharmacology
  • Cardiovascular Surgery

Background:

  • Drugs administered during cardiac anesthesia may be sequestered in the extracorporeal circuit.
  • The in vivo impact of this sequestration on plasma drug concentration is not well understood.

Purpose of the Study:

  • To evaluate the in vitro sequestration of propofol in the extracorporeal circuit.
  • To determine if hemodilution explains changes in plasma propofol concentration during cardiopulmonary bypass.

Main Methods:

  • In vitro experiments using a closed extracorporeal circuit with controlled temperature and physiological parameters.
  • High-performance liquid chromatography (HPLC) for propofol concentration measurement.
  • In vivo study in 14 patients receiving continuous propofol infusion during cardiopulmonary bypass.

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Main Results:

  • In vitro, measurable propofol levels decreased from approximately 65% to 25% of the predicted concentration within 120 minutes.
  • In vivo data indicated a reduction in plasma propofol concentration after initiation of cardiopulmonary bypass.

Conclusions:

  • Propofol sequestration in the extracorporeal circuit is significant.
  • Hemodilution alone does not fully account for the observed decrease in plasma propofol concentration during cardiopulmonary bypass.