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CARDIOVASCULAR ANESTHESIA

Reduction in Air Bubble Size Using Perfluorocarbons During Cardiopulmonary Bypass in the Rat

Kenji Yoshitani, MD^*, Fellery de Lange, MD^*, Qing Ma, MD^*, Hilary P. Grocott, MD, FRCPC^*, and G. Burkhard Mackensen, MD^*

From the *Department of Anesthesiology, Duke University Medical Center; and Division of Perioperative Care and Emergency Medicine, University Medical Center, Utrecht, the Netherlands.

Address correspondence and reprint requests to G. Burkhard Mackensen, MD, Department of Anesthesiology, Duke University Medical Center, DMUC Box 3094, Durham, NC 27710. Address e-mail to b.mackensen{at}duke.edu.

BACKGROUND: Perfluorocarbon (PFC) emulsions are artificial oxygen-carrying compounds with a high solubility for gases that have experimentally been shown to ameliorate cerebral air embolism. Cerebral air embolism has been associated with adverse cerebral outcomes after cardiac surgery using cardiopulmonary bypass (CPB). We designed this study to test whether PFC emulsions could reduce the volume of bubbles within the CPB circuit.

METHODS: Male Sprague-Dawley rats undergoing 60 min of normothermic nonpulsatile CPB were randomized to one of the three groups. The PFC group (n = 10) received 60% O₂/36% N₂/4% CO₂ via the membrane oxygenator and 2.7 g/kg (4.5 mL/kg) of PFC into the venous reservoir; the control group (n = 10) received the same gas mixture and 4.5 mL/kg of saline; the N₂O group (n = 6) was exposed to 36% N₂O/60% O₂/4% CO₂ and received 4.5 mL/kg of saline. After 10 min and 35 min of CPB, 400 µL of air was injected into a bubble chamber in the CPB circuit. After 20 min, the bubble was removed for volumetric analysis.

RESULTS: Compared with baseline, the bubble decreased 13% ± 5% in size in the PFC group and increased 46% ± 9% in the nitrous oxide group, both of these changes significantly different from the control group (P < 0.0001).

CONCLUSION: The results suggest that PFC administration may be useful in reducing the volume of gaseous bubbles present during CPB.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999