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Philipps-Universität Marburg
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Abstract
Theoretical considerations suggest that cardiac output may have major impact on the pharmacokinetics of drugs administered continuously during anaesthesia. The primary aim of this study is to simulate the effect of cardiac output on the context-sensitive decrement times of isoflurane, sevoflurane and desflurane.
The uptake, distribution and excretion of desflurane, isoflurane, and sevoflurane were studied using the Gas Man® computer simulation program. All simulations were performed, using the validated standard 70 kg GasMan® simulation model with the standard distribution and gas flows. After decreasing the partial pressure of 0.33 MAC (defined as the MACawake), different cardiac output levels were simulated. Different scenarios were simulated systematically by variegating duration of drug administration (1-15 hours), the volatile anesthetic, cardiac output and tissue flows to determine the 90% and 95% decrement in the vessel rich group (including the highly perfused tissue of the central nervous system).
With increasing duration of administration, the 90%-and 95%-decrement times were reached earlier with less cardiac output (CO). Regardless of the chosen CO and duration of anaesthetic administration, desflurane was eliminated faster than sevoflurane and the latter faster than isoflurane. Depending on the duration of administration and the chosen anesthetic, the complete elimination occurs.
The CO has a major impact on the decrement-times of inhaled anesthetics and can affect the speed of elimination significantly. An over-proportional increase in cardiac output after higher durations of anaesthesia could produce a prolongation in elimination of inhaled anesthetics. This prolongation might be due to an increased distribution of volatile anesthetic from slower equilibrating compartments.
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Dates
Created: 2018Issued: 2018-12-10Updated: 2018-12-10
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
Inhaled AnaestheticsContext-Sensitive Decrement timesGas Man
DFG-subjects
HämodynamikKinetik volatiler AnästhetikaGas Man
DDC-Numbers
610
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Bobka, Fjodor Alexander: Einfluss der Hämodynamik auf die Kinetik volatiler Anästhetika. : Philipps-Universität Marburg 2018-12-10. DOI: https://doi.org/10.17192/z2018.0276.
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This item has been published with the following license: In Copyright