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Anaesthesia


Title:The effect of cardiac output changes on end-expired volatile anaesthetic concentrations--a theoretical study
Author(s):Kennedy, R. R.Baker, A. B.
Address:Department of Anaesthesia, The Christchurch School of Medicine, Christchurch, New Zealand. ross.kennedy@chmeds.ac.nz
Year:2001 Nov
Journal Title:Anaesthesia
Page Number:1034-40
Language:eng
Volume:56
Issue:11
ISSN/ISBN:0003-2409 (Print). 0003-2409 (Linking)
Abstract:Cardiac output is one of the major determinants of the rate of uptake, and therefore the end-expired concentration (F(E')) of volatile anaesthetic agents. The purpose of this theoretical study was to explore the effect of cardiac output changes on F(E') for a range of volatile anaesthetics. A multicompartment model of anaesthetic uptake and distribution which produces constant values of F(E') was used. The minimum detectable change in cardiac output was determined for a variety of anaesthetic agents for four patterns of cardiac output change. The effect of a step change in cardiac output from 5 to 10 l.min(-1) was also recorded. The smallest cardiac output changes (average 33%) were detected with isoflurane. As blood solubility increased or decreased, larger cardiac output changes were needed before they could be detected. With a large step change in cardiac output and with increasing solubility, the final change in F(E') increased but the initial rate of change of F(E') is decreased. A significant cardiac output change will produce a change in volatile anaesthetic uptake. An unexpected change in F(E') should be considered as a possible signal of a sudden cardiac output change. The difference between agents may represent a balance between the amount of agent taken up and the size of the tissue 'sink' for that agent.

 
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