Effects of xenon anaesthesia on the circulatory response to hypoventilation |
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Authors: | Baumert J-H Hecker K E Hein M Reyle-Hahn M Horn N A Rossaint R |
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Institution: | Anaesthesiology Clinic, Universitaetsklinikum Aachen, Germany. 1 Anaesthesia Department, Waldkrankenhaus Berlin-Spandau, Germany |
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Abstract: | Background. Circulatory response to hypoventilation is aimedat eliminating carbon dioxide and maintaining oxygen delivery(DO2) by increasing cardiac output (CO). The hypothesis thatthis increase is more pronounced with xenon than with isofluraneanaesthesia was tested in pigs. Methods. Twenty pigs received anaesthesia with xenon 0.55 MAC/remifentanil0.5 µg kg1 min1 (group X, n=10) or isoflurane0.55 MAC/remifentanil 0.5 µg kg1min1 (groupI, n=10). CO, heart rate (HR), mean arterial pressure (MAP)and left ventricular fractional area change (FAC) were measuredat baseline, after 5 and 15 min of hypoventilation and after5, 15 and 30 min of restored ventilation. Results. CO increased by 1020% with both anaesthetics,with an equivalent rise in HR, maintaining DO2 in spite of a20% reduction in arterial oxygen content. Decreased left ventricular(LV) afterload during hypoventilation increased FAC, and thiswas more marked with xenon (0.600.66, P<0.05 comparedwith baseline and isoflurane). This difference is attributedto negative inotropic effects of isoflurane. Increased pulmonaryvascular resistance during hypoventilation was found with bothanaesthetics. Conclusion. The cardiovascular effects observed in this modelof moderate hypoventilation were sufficient to maintain DO2.Although the haemodynamic response appeared more pronouncedwith xenon, differences were not clinically relevant. An increasein FAC with xenon is attributed to its lack of negative inotropiceffects. |
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Keywords: | anaesthetics gases xenon complications hypercarbia complications hypoxaemia monitoring trans-oesophageal echocardiography |
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