Cited 3 times since 2014 (0.5 per year) source: Scopus Perfusion, Volume 30, Issue 4, 01 August 2014, Pages 295-301 Sevoflurane-enriched blood cardioplegia: the intramyocardial delivery of a volatile anesthetic. van der Baan A, Kortekaas KA, van Es E, Meier S, Klautz RJ, Engbers FH
Myocardial ischemia/reperfusion injury is a major problem in cardiac surgery, characterized by an enhanced inflammatory response postoperatively. Sevoflurane has anti-inflammatory effects and may attenuate this injury. This study describes a novel approach to using sevoflurane as a local anti-inflammatory drug and not as an anesthetic. Therefore, a pediatric oxygenator with a sevoflurane vaporizer was integrated into the blood cardioplegia system of an adult bypass system. In addition, a gas blender was implemented to regulate pO2 and pCO2 concentrations in the cardioplegia. This proof-of-principle study was tested in vivo and shows that it is feasible to deliver sevoflurane locally while regulating O2 and CO2 concentrations. Moreover, this set-up enables one to use only the specific cardioprotective features of sevoflurane. Inflammatory responses were attenuated, both locally (i.e. the heart) as well as systemically through intramyocardial delivery of sevoflurane.
Keywords: Inflammation, Cardiopulmonary bypass, Blood cardioplegia, Sevoflurane, Oxygenator