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The influence of xenon, nitrous oxide and nitrogen on gas bubble expansion during cardiopulmonary bypass

Published online by Cambridge University Press:  11 May 2005

H. P. Grocott ,
Y. Sato ,
H. M. Homi  and
B. E. Smith
H. P. Grocott
Affiliation:
Duke University Medical Center, Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Durham, NC, USA
Y. Sato
Affiliation:
Hamamatsu University, Shizuoka General Hospital, School of Medicine, Hamamatsu, Japan
H. M. Homi
Affiliation:
Duke University Medical Center, Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Durham, NC, USA
B. E. Smith
Affiliation:
Duke University Medical Center, Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Durham, NC, USA
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Extract

Summary

Background and objective: Xenon may have favourable applications in the setting of cardiac surgery. Its advantages include a desirable haemodynamic profile as well as potential cardiac and neuroprotective properties. However, its low solubility may lead to enhanced diffusion into enclosed gas spaces. The purpose of this study was to compare the effects of xenon (Xe), nitrous oxide (N2O) and nitrogen (N2) on gas bubble size during cardiopulmonary bypass (CPB).

Methods: Rats were randomized to receive 70% Xe, 26% oxygen (O2), 4% carbon dioxide (CO2) (xenon group); 70% N2O, 26% O2, 4% CO2 (nitrous oxide group) or 70% N2, 26% O2, 4% CO2 (nitrogen group) during 90 min of normothermic CPB. Small gas bubbles (300–500 μL; n = 12 per group) were injected into a bubble chamber on the venous side of the bypass circuit. After 10 min of equilibration, they were removed for volumetric analysis.

Results: The increase in bubble size was 2 ± 2% with nitrogen, 17 ± 6% with xenon (P = 0.0192 vs. nitrogen) and 63 ± 23% with nitrous oxide (P = 0.0001 vs. nitrogen). The nitrous oxide group had significantly increased bubble size compared to the xenon group (P = 0.0001).

Conclusions: During CPB, xenon anaesthesia produced a small increase in gas bubble size compared to nitrogen. Nitrous oxide resulted in significantly larger bubbles compared to both nitrogen and xenon.

Keywords

ANAESTHETICS INHALATION, xenon, nitrous oxide, isofluraneMICROBUBBLESCARDIAC SURGICAL PROCEDURESCARDIOPULMONARY BYPASS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 5 , May 2005 , pp. 353 - 358
Copyright
© 2005 European Society of Anaesthesiology

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References

Rossaint R, Reyle-Hahn M, Schulte Am Esch J, et al. Multicenter randomized comparison of the efficacy and safety of xenon and isoflurane in patients undergoing elective surgery. Anesthesiology 2003; 98: 6–13.Google Scholar
Goto T. Is there a future for xenon anesthesia? Can J Anaesth 2002; 49: 335–338.Google Scholar
Goto T, Nakata Y, Morita S. Will xenon be a stranger or a friend? The cost, benefit, and future of xenon anesthesia. Anesthesiology 2003; 98: 1–2.Google Scholar
Goto T, Saito H, Shinkai M, et al. Xenon provides faster emergence from anesthesia than does nitrous oxide– sevoflurane or nitrous oxide–isoflurane. Anesthesiology 1997; 86: 1273–1278.Google Scholar
Sanders RD, Franks NP, Maze M. Xenon: no stranger to anaesthesia. Br J Anaesth 2003; 91: 709–717.Google Scholar
Bedi A, McBride WT, Armstrong MA, Murray JM, Fee JP. Xenon has no effect on cytokine balance and adhesion molecule expression within an isolated cardiopulmonary bypass system. Br J Anaesth 2002; 89: 546–550.Google Scholar
Ma D, Yang H, Lynch J, Franks N, Maze M, Grocott H. Xenon attenuates cardiopulmonary bypass-induced neurologic and neurocognitive dysfunction in the rat. Anesthesiology 2003; 98: 690–698.Google Scholar
Lynch III C, Baum J, Tenbrinck R, Weiskopf R. Xenon anesthesia. Anesthesiology 2000; 92: 865–868.Google Scholar
Dingley J, Findlay GP, Foex BA, et al. A closed xenon anesthesia delivery system. Anesthesiology 2001; 94: 173–176.Google Scholar
Reinelt H, Schirmer U, Marx T, Topalidis P, Schmidt M. Diffusion of xenon and nitrous oxide into the bowel. Anesthesiology 2001; 94: 475–477.Google Scholar
Muth CM, Shank ES. Gas embolism. New Engl J Med 2000; 342: 476–482.Google Scholar
Lockwood G. Expansion of air bubbles in aqueous solutions of nitrous oxide or xenon. Br J Anaesth 2002; 89: 282–286.Google Scholar
Sta Maria N, Eckmann DM. Model predictions of gas embolism growth and reabsorption during xenon anesthesia. Anesthesiology 2003; 99: 638–645.Google Scholar
Einot I, Gabriel KR. A study of the powers of several methods of multiple comparisons (in applications). J Am Stat Assoc 1975; 70: 574–583.Google Scholar
Cullen SC, Gross EG. The anesthetic properties of xenon in animals and human beings, with additional observations on Krypton. Science 1951; 113: 580–582.Google Scholar
Preckel B, Mullenheim J, Moloschavij A, Thamer V, Schlack W. Xenon administration during early reperfusion reduces infarct size after regional ischemia in the rabbit heart in vivo. Anesth Analg 2000; 91: 1327–1332.Google Scholar
Homi HM, Yokoo N, Ma D, et al. The neuroprotective effect of xenon administration during transient middle cerebral artery occlusion in mice. Anesthesiology 2003; 99: 876–881.Google Scholar
Pugsley W, Klinger L, Paschalis C, Treasure T, Harrison M, Newman S. The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning. Stroke 1994; 25: 1393–1399.Google Scholar
Grocott HP, Amory DW, Lowry E, Newman MF, Lowe JE, Clements FM. Cerebral embolization during transmyocardial laser revascularization. J Thorac Cardiovasc Surg 1997; 114: 856–858.Google Scholar
Willcox TW, Mitchell SJ, Gorman DF. Venous air in the bypass circuit: a source of arterial line emboli exacerbated by vacuum-assisted drainage. Ann Thorac Surg 1999; 68: 1285–1289.Google Scholar
Borger MA, Feindel CM. Cerebral emboli during cardiopulmonary bypass: effect of perfusionist interventions and aortic cannulas. J Extra Corp Technol 2002; 34: 29–33.Google Scholar
Ma D, Wilhelm S, Maze M, Franks NP. Neuroprotective and neurotoxic properties of the ‘inert’ gas, xenon. Br J Anaesth 2002; 89: 739–746.Google Scholar
Wilhelm S, Ma D, Maze M, Franks NP. Effects of xenon on in vitro and in vivo models of neuronal injury. Anesthesiology 2002; 96: 1485–1491.Google Scholar