Sodium nitroprusside metabolism during hypothermic cardiopulmonary bypass
Küçük Resim Yok
Tarih
1993
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Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
To prevent the systemic vascular resistance increase during cardiopulmonary bypass (CPB), sodium nitroprusside (SNP) was used at infusion rates as suggested in normothermia (0.5-8 µg/kg/min) in randomly selected 16 patients undergoing coronary artery bypass grafting (CABG). SNP infusion was started when mean arterial blood pressure (MAP) increased over 80 mmHg and continued until it decreased to 60 mmHg. The mean SNP doses and infusion rates and related blood cyanide (CN-) levels were measured in 10 patients and plasma thiocyanate (SCN-) levels in 16 patients before, during and after hypothermia. At the beginning of CPB, but before SNP infusion, blood CN- and plasma SCN levels are 0.437 ± 0.05 µmol/L and 0.250 ± 0.02 mg/dl respectively. At 28°C, blood CN- level was 0.712 ± 0.15 µmol/L and plasma SCN- level was 0.313 ± 0.03 mg/dl. At the end of hypothermia, they were 1.468 ± 0.29 µmol/L and 0.405 ± 0.04 mg/dl respectively. The highest blood CN- level observed was in the third blood sample (1.468 ± 0.29) taken at the end of hypothermia. The peak plasma SCN level was reached (0.623 ± 0.12) four hours after rewarming. No patient showed toxicity symptoms and blood levels never reached to toxic levels. In conclusion, SNP can be used safely at infusion rates as suggested in normothermia in CPB. But especially in prolonged hypothermia CPB, the risk of CN-toxicity must be considered and metabolic status of the patient must be examined carefully.
Açıklama
Anahtar Kelimeler
Kaynak
Turk Anesteziyoloji ve Reanimasyon
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
21
Sayı
2
