Tricks, tips, and literature review on the adapted vaporize system to deliver volatile agents during cardiopulmonary bypass

Caetano Neto, Francesco Simone, Luigi Cassara, Carlos Gustavo Silva, Thiago Augusto Cardoso, Francesco Carco, Alberto Zangrillo, Giovanni Landoni

Research output: Contribution to journalArticlepeer-review


Background: Recently, evidence of cardio-protection and reduction in mortality due to the use of volatile agents during cardiac surgery led to an increase in their use during cardiopulmonary bypass (CPB). These findings seem to be enhanced when the volatile agents are used during all the surgical procedure, including the CPB period. Aims: Since the administration of volatile agents through CPB can be beneficial to the patients, we decided to review the use of volatile agents vaporized in the CPB circuit and to summarize some tricks and tips of this technique using our 10-year experience of Brazilian and Italian centers with a large volume of cardiac surgeries. Study Setting: Hospital. Methods: A literature review. Results: During the use of the volatile agents in CPB, it is very important to analyze all gases that come in and go out of the membrane oxygenators. The proper monitoring of inhaled and exhaled fraction of the gas allows not only monitoring of anesthesia level, but also the detection of possible leakage in the circuit. Any volatile agent in the membrane oxygenator is supposed to pollute the operating theater. This is the major reason why proper scavenging systems are always necessary when this technique is used. Conclusion: While waiting for industry upgrades, we recommend that volatile agents should be used during CPB only by skilled perfusionists and physicians with the aim to reduce postoperative morbidity and mortality.

Original languageEnglish
Pages (from-to)240-244
Number of pages5
JournalAnnals of Cardiac Anaesthesia
Issue number2
Publication statusPublished - Apr 1 2016


  • Anesthesia
  • Cardiac surgery
  • Cardiopulmonary bypass
  • Sevoflurane
  • Volatile anesthetic

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Cardiology and Cardiovascular Medicine


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