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. 2021 Oct 4;33(4):625-627.
doi: 10.1093/icvts/ivab143.

Propofol pharmacokinetics and pharmacodynamics-a perspective in minimally invasive extracorporeal circulation

Ignazio Condello  1 , Giuseppe Santarpino  1   2   3 , Flavio Fiore  1 , Nicola Di Bari  4 , Giuseppe Speziale  1 , Marco Moscarelli  1 , Giuseppe Nasso  1
Affiliations

Propofol pharmacokinetics and pharmacodynamics-a perspective in minimally invasive extracorporeal circulation

Ignazio Condello et al. Interact Cardiovasc Thorac Surg. .

Abstract

There is limited evidence as to the pharmacokinetic changes expected in adults with extracorporeal technologies. Drugs may be taken up by various components of the cardiopulmonary bypass circuit itself. Issues include the increased volume of the circuit leading to haemodilution; the sequestration of lipophilic drugs within the circuit tubing; and the absorption of proteins, especially albumin, onto the circuit, which can result in increased free drug. However, in this context, the aspect of pharmacokinetics and pharmacodynamics during minimally invasive extracorporeal circulation has not been described and evidenced by scientific studies. In this single-centre control study of 60 patients undergoing isolated coronary artery bypass grafting, we present the results focused on postoperative albumin values and intraoperative propofol dosages in patients undergoing surgery with minimally invasive (n = 30) versus conventional extracorporeal circulation (n = 30). In the minimally invasive extracorporeal circulation group, a lower propofol dosage titrated to a bispectral index of 40-45 was used during coronary artery bypass grafting, and an improvement of postoperative concentration of serum albumin was observed compared to the conventional extracorporeal circulation group.

Keywords: Albumin; Cardiopulmonary bypass; Minimally invasive extracorporeal circulation; Pharmacodynamics; Pharmacokinetics; Propofol.

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References

    1. Puis L, Milojevic M, Boer C, De Somer FMJJ, Gudbjartsson T, van den GJ. et al.; EACTS/EACTA/EBCP Committee Reviewers. 2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery. Interact CardioVasc Thorac Surg 2020;30:161–202. - PMC - PubMed
    1. Buylaert WA, Herregods LL, Mortier EP, Bogaert MG.. Cardiopulmonary bypass and the pharmacokinetics of drugs. An update. Clin Pharmacokinet 1989;17:10–26. - PubMed
    1. El-Baraky IA, Abbassi MM, Marei TA, Sabry NA.. Obesity does not affect propofol pharmacokinetics during hypothermic cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2016;30:876–83. - PubMed
    1. Condello I, Santarpino G, Nasso G, Moscarelli M, Fiore F, Speziale G.. Associations between oxygen delivery and cardiac index with hyperlactatemia during cardiopulmonary bypass. JTCVS Tech 2020;2:92–9. - PMC - PubMed
    1. Moscarelli M, Condello I, Fattouch K, Punjabi P, Ajello V, Solimando C. et al. Dopamine optimizes venous return during cardiopulmonary bypass and reduces the need for postoperative blood transfusion. ASAIO J 2019;65:882–7. - PubMed

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