88268
document
Effects of enflurane and isoflurane on splanchnic oxygenation in humans . STUDY OBJECTIVES To determine the effects of enflurane and isoflurane on hepatic venous oxygen saturation ( ShvO2 ) and splanchnic oxygen ( O2 ) extraction . To measure hemodynamic parameters and ShvO2 , mixed venous , and arterial lactate concentrations during enflurane and isoflurane anesthesia . DESIGN Randomized , prospective study . SETTING University hospital . PATIENTS 20 ASA physical status I , II , and III adults , who underwent major abdominal surgery requiring mechanical ventilation a few hours postoperatively . INTERVENTIONS After placement of catheters in the pulmonary artery , radial artery , peripheral and right hepatic vein , one hour postoperatively either enflurane or isoflurane was applied at different minimum alveolar concentration ( MAC ) of 0.5 , 1.0 , and 1.5 in a randomized order . MEASUREMENTS AND MAIN RESULTS Before and 10 minutes after administration of each desired end-expiratory anesthetic concentration , the following parameters were determined : hemodynamic parameters , arterial ( SaO2 ) , mixed venous ( SvO2 ) , and hepatic venous oxygen saturations , systemic and splanchnic O2 extraction , arterial , mixed venous , and hepatic venous lactate concentrations . Cardiac output ( CO ) and mean arterial pressure ( MAP ) decreased in a dose dependent manner . SaO2 , SvO2 , and systemic O2 extraction remained unchanged with enflurane and isoflurane anesthesia . In the enflurane group , but not in the isoflurane group , ShvO2 decreased with increasing inhalational concentrations . This decrease in ShvO2 reflected an increase in splanchnic O2 extraction with enflurane ; in contrast to isoflurane . CONCLUSIONS Enflurane causes a decrease in ShvO2 , which indicates an impairment of splanchnic perfusion corresponding to the reduction in CO and MAP in a dose-dependent manner . Isoflurane maintains splanchnic perfusion in contrast to enflurane .
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Intervention_Pharmacological
enflurane
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Intervention_Pharmacological
isoflurane
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Intervention_Pharmacological
enflurane
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Intervention_Pharmacological
isoflurane
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Intervention_Pharmacological
enflurane
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Intervention_Pharmacological
isoflurane
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Intervention_Pharmacological
enflurane
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Intervention_Pharmacological
isoflurane
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Intervention_Pharmacological
enflurane
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Intervention_Pharmacological
enflurane
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Intervention_Pharmacological
isoflurane
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Intervention_Pharmacological
Enflurane
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Intervention_Pharmacological
Isoflurane
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Intervention_Pharmacological
enflurane
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Outcome_Physical
splanchnic oxygenation
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Outcome_Physical
hepatic venous oxygen saturation ( ShvO2 ) and splanchnic oxygen ( O2 ) extraction .
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Outcome_Physical
hemodynamic parameters
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Outcome_Physical
arterial ( SaO2 ) , mixed venous ( SvO2 )
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Outcome_Physical
hepatic venous oxygen saturations
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Outcome_Physical
systemic and splanchnic O2 extraction , arterial , mixed venous , and hepatic venous lactate concentrations
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Outcome_Physical
Cardiac output ( CO ) and mean arterial pressure ( MAP )
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Outcome_Physical
SaO2
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Outcome_Physical
SvO2
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Outcome_Physical
systemic O2 extraction
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Outcome_Physical
ShvO2
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Outcome_Physical
ShvO2
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Outcome_Physical
splanchnic O2 extraction
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Outcome_Physical
ShvO2
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Outcome_Physical
splanchnic perfusion
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Outcome_Physical
CO
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Outcome_Physical
MAP
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Outcome_Physical
splanchnic perfusion
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Participant_Condition
splanchnic oxygenation
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Participant_Sample-size
20
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Participant_Age
adults