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. 2005 Dec;37(4):369-72.

Fentanyl plasma levels after modified ultrafiltration in infant heart surgery

Andreas H Taenzer  1 , Robert Groom, Reed D Quinn
Affiliations

Fentanyl plasma levels after modified ultrafiltration in infant heart surgery

Andreas H Taenzer et al. J Extra Corpor Technol. 2005 Dec.

Abstract

Modified ultrafiltration (MUF) is a novel application of ultrafiltration to remove excess water after cardiopulmonary bypass in pediatric patients that was first reported in 1991. It has gained widespread use as an important adjunct to fluid management in neonates, infants, and pediatric cardiac surgery patients. Now more than two decades after its original description, the exact mechanism of action and effects of this therapy are still a matter of discussion. The aim of this study was to determine the effects of MUF on plasma fentanyl levels using a two-phase in vitro and in vivo study. We designed an in vitro experimental model to simulate MUF that allowed measurement of plasma fentanyl levels while eliminating biologic variables. Plasma fentanyl levels were measured during five consecutive operations on neonates and infants undergoing repair of congenital heart defects. Increases in plasma fentanyl levels were found in vitro as well as in vivo. Fentanyl plasma levels more than doubled after MUF (increased by a factor of 2.22, from 12.4 to 27.5 ng/ml in vivo). The increase in plasma fentanyl levels needs to be taken into account when delivering anesthetic care and when analyzing the effect of MUF on outcome variables.

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Conflict of interest statement

The senior author has stated that authors have reported no material, financial or other relationship with any healthcare-related business or other entity whose products or services are discussed in this paper.

Figures

Figure 1.
Figure 1.
Fentanyl plasma levels in vivo (experimental set-up). T1, baseline after separation from CPB and before MUF; T2, after completion of 50% of MUF; T3, after the end of MUF.
Figure 2.
Figure 2.
Fentanyl plasma levels in vivo. T1, baseline after separation from CPB and before MUF; T2, after completion of 50% of MUF; T3, after the end of MUF.
Figure 3.
Figure 3.
Circuit setup.
See this image and copyright information in PMC

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