PMID: 9161903May 1, 1997Paper

Elimination of drugs and toxins during cardiopulmonary bypass

Journal of Cardiothoracic and Vascular Anesthesia
D A Rosen, K R Rosen

Abstract

Cardiopulmonary bypass (CPB) creates a myriad of pharmacological and physiological changes. Some of these changes have been studied in isolated in vitro studies. Integrating an in vitro system into an in vivo process is so complicated that many pharmacological studies simply avoid the bypass period. For the most part, the studies that do examine the bypass period deal with a single drug, reporting how it does or does not produce a predicted concentration on initiation, maintenance and termination of CPB. Based on the isolated results of these studies, this review hypothesizes a model that explains how different substances interact with the CPB system. A summary of the review's findings include the following: 1) drugs with a smaller volume of distribution are more likely to be effected; 2) the pharmacokinetic effects of lipophilic drugs undergo more alterations than hydrophilic drugs; and 3) protein binding minimizes alterations of lipophilic drugs and increase alterations of hydrophilic drugs.

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Citations

Jan 2, 2001·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·D WithingtonF Varin
Sep 24, 2010·Intensive Care Medicine·E D WildschutD Tibboel
Jul 30, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Koen RaedscheldersDavid M Ansley
Jan 30, 2010·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Joel ParlowRachel Phelan
Mar 14, 2000·Acta Anaesthesiologica Scandinavica·B Mets
Mar 30, 2011·Antimicrobial Agents and Chemotherapy·Megan H NguyenLoren G Miller
Nov 30, 1999·Anesthesia and Analgesia·C J O'ConnorK J Tuman
Jul 8, 2008·Annals of Cardiac Anaesthesia·Thomas M HemmerlingDavid Bracco
Jan 29, 2005·Paediatric Anaesthesia·Todd SmithJoseph D Tobias
May 19, 2009·Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas·M J C CarmonaS R C J Santos
May 27, 2005·Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas·M J C CarmonaS R C J Santos
Mar 1, 2017·British Journal of Clinical Pharmacology·Ralph GertlerGunther Wiesner
Jun 5, 1999·Anesthesia and Analgesia·D J Cook
Mar 20, 2015·Anesthesia and Analgesia·Aaron E BarryMartin J London
Sep 14, 2021·Frontiers in Cardiovascular Medicine·Annewil van SaetDick Tibboel

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