Abstract
Objectives Recently, evidence of reduction in mortality due to the use of volatile agents during cardiac surgery led to an increase in their use during cardiopulmonary bypass (CPB). Because this technique could be beneficial to patients, but might present several hazards to new users, the authors decided to perform a systematic review of the main problems and complications. Design Systematic literature review. Setting Hospital. Participants Adults undergoing cardiac surgery with use of volatile anesthetic agents during CPB. Intervention Several databases were searched for pertinent studies to identify all reports on the adverse events of using volatile agents during CPB and all randomized controlled trials using volatile agents during CPB. Measurements and Main Results Six nonrandomized trials reporting adverse events or complications with the use of volatile agents during CPB for cardiac surgery were identified: 2 reporting low transfer of isoflurane to the blood with diffusion membrane oxygenators; 2 reporting iatrogenic causes of damage after spilling liquid isoflurane onto the surface of the membrane oxygenators while filling the vaporizer; and 2 suggesting that the use of volatile agents during CPB increased the pollution of the room and the risk of occupational exposure of the operating room staff. On the other hand, no adverse event was reported in 19 studies that randomized 1,195 patients to receive isoflurane, desflurane, or sevoflurane during CPB. Conclusion It is mandatory for industry to provide safe and easy-to-use devices to administer volatile agents during CPB with the standard membrane oxygenators.
| Original language | English |
|---|---|
| Pages (from-to) | 84-89 |
| Number of pages | 6 |
| Journal | Journal of Cardiothoracic and Vascular Anesthesia |
| Volume | 28 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Feb 2014 |
Fingerprint
Keywords
- anesthesia
- cardiac surgery
- cardiopulmonary bypass
- desflurane
- isoflurane
- safety
- sevoflurane
- volatile anesthetic
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Anesthesiology and Pain Medicine
Cite this
Use of volatile anesthetics during cardiopulmonary bypass : A systematic review of adverse events. / Nigro Neto, Caetano; Landoni, Giovanni; Cassarà, Luigi; De Simone, Francesco; Zangrillo, Alberto; Tardelli, Maria Angela.
In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 28, No. 1, 02.2014, p. 84-89.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Use of volatile anesthetics during cardiopulmonary bypass
T2 - A systematic review of adverse events
AU - Nigro Neto, Caetano
AU - Landoni, Giovanni
AU - Cassarà, Luigi
AU - De Simone, Francesco
AU - Zangrillo, Alberto
AU - Tardelli, Maria Angela
PY - 2014/2
Y1 - 2014/2
N2 - Objectives Recently, evidence of reduction in mortality due to the use of volatile agents during cardiac surgery led to an increase in their use during cardiopulmonary bypass (CPB). Because this technique could be beneficial to patients, but might present several hazards to new users, the authors decided to perform a systematic review of the main problems and complications. Design Systematic literature review. Setting Hospital. Participants Adults undergoing cardiac surgery with use of volatile anesthetic agents during CPB. Intervention Several databases were searched for pertinent studies to identify all reports on the adverse events of using volatile agents during CPB and all randomized controlled trials using volatile agents during CPB. Measurements and Main Results Six nonrandomized trials reporting adverse events or complications with the use of volatile agents during CPB for cardiac surgery were identified: 2 reporting low transfer of isoflurane to the blood with diffusion membrane oxygenators; 2 reporting iatrogenic causes of damage after spilling liquid isoflurane onto the surface of the membrane oxygenators while filling the vaporizer; and 2 suggesting that the use of volatile agents during CPB increased the pollution of the room and the risk of occupational exposure of the operating room staff. On the other hand, no adverse event was reported in 19 studies that randomized 1,195 patients to receive isoflurane, desflurane, or sevoflurane during CPB. Conclusion It is mandatory for industry to provide safe and easy-to-use devices to administer volatile agents during CPB with the standard membrane oxygenators.
AB - Objectives Recently, evidence of reduction in mortality due to the use of volatile agents during cardiac surgery led to an increase in their use during cardiopulmonary bypass (CPB). Because this technique could be beneficial to patients, but might present several hazards to new users, the authors decided to perform a systematic review of the main problems and complications. Design Systematic literature review. Setting Hospital. Participants Adults undergoing cardiac surgery with use of volatile anesthetic agents during CPB. Intervention Several databases were searched for pertinent studies to identify all reports on the adverse events of using volatile agents during CPB and all randomized controlled trials using volatile agents during CPB. Measurements and Main Results Six nonrandomized trials reporting adverse events or complications with the use of volatile agents during CPB for cardiac surgery were identified: 2 reporting low transfer of isoflurane to the blood with diffusion membrane oxygenators; 2 reporting iatrogenic causes of damage after spilling liquid isoflurane onto the surface of the membrane oxygenators while filling the vaporizer; and 2 suggesting that the use of volatile agents during CPB increased the pollution of the room and the risk of occupational exposure of the operating room staff. On the other hand, no adverse event was reported in 19 studies that randomized 1,195 patients to receive isoflurane, desflurane, or sevoflurane during CPB. Conclusion It is mandatory for industry to provide safe and easy-to-use devices to administer volatile agents during CPB with the standard membrane oxygenators.
KW - anesthesia
KW - cardiac surgery
KW - cardiopulmonary bypass
KW - desflurane
KW - isoflurane
KW - safety
KW - sevoflurane
KW - volatile anesthetic
UR - http://www.scopus.com/inward/record.url?scp=84892618675&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84892618675&partnerID=8YFLogxK
U2 - 10.1053/j.jvca.2013.05.030
DO - 10.1053/j.jvca.2013.05.030
M3 - Article
C2 - 24295716
AN - SCOPUS:84892618675
VL - 28
SP - 84
EP - 89
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 1
ER -