What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery bypass grafts (n=10). Intervention: Isoflurane-oxygen anesthesia. Primary outcome: Myocardial lactate production (evidence of global ischemia).

What question did this study set out to answer?

The study investigates the effects of isoflurane anesthesia on myocardial metabolism and hemodynamics during coronary artery bypass graft surgery.

August 1, 1986Survey of Anesthesiology

Myocardial Metabolis and Hemodynamic Responses with Isoflurane Anesthesia for Coronary Arterial Surgery

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Key result

Isoflurane-oxygen anesthesia during coronary artery bypass grafting decreased coronary resistance by 23% but caused myocardial lactate production, indicating global ischemia, in 30% of patients.

Why the study?

Does isoflurane-oxygen anesthesia affect myocardial metabolism and hemodynamics in patients undergoing coronary artery bypass grafting?

Key Points

The study investigates the effects of isoflurane anesthesia on myocardial metabolism and hemodynamics during coronary artery bypass graft surgery.
Ten patients were induced and maintained on isoflurane-oxygen for anesthesia during surgery.
Cardiac output, pressures, blood flow, and metabolic markers were measured at multiple time points before and after anesthesia.
Systolic arterial pressure was reduced by 33% to study hemodynamic changes.
Coronary resistance decreased by 23%, and coronary sinus oxygen content increased by 56%.
Myocardial lactate production occurred in 30% of patients, indicating global ischemia despite hemodynamic changes.
Induction of anesthesia was not smooth in 30% of patients, suggesting potential complications.

Study Design

Type

Observational (n=10)

Structured PICO

Does isoflurane-oxygen anesthesia affect myocardial metabolism and hemodynamics in patients undergoing coronary artery bypass grafting?

Population

10 patients with preserved ventricular function and no hypertension undergoing coronary artery bypass grafts.

Intervention

Isoflurane-oxygen for induction and maintenance of anesthesia.

Outcome

Hemodynamic responses (cardiac output, arterial and central pressures, coronary sinus blood flow) and myocardial metabolism (arterial and coronary sinus oxygen, Hb, and lactate contents) measured before, during, and after anesthesia.surrogate

Isoflurane anesthesia during CABG can cause coronary vasodilation but may concomitantly lead to anaerobic metabolism and regional ischemia.

Discussion

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Implication

Isoflurane may cause myocardial ischemia during CABG; leaves open its safety versus alternatives in coronary disease.

Cite This Study

Moffitt et al. (1986) conducted an observational in Coronary artery bypass grafts (n=10). Isoflurane-oxygen anesthesia was evaluated on Myocardial lactate production (evidence of global ischemia). Isoflurane-oxygen anesthesia during coronary artery bypass grafting decreased coronary resistance by 23% but caused myocardial lactate production, indicating global ischemia, in 30% of patients.

synapsesocial.com/papers/6a3360a4cce949c3f40e50db https://doi.org/10.1097/00132586-198608000-00020

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Myocardial Metabolis and Hemodynamic Responses with Isoflurane Anesthesia for Coronary Arterial Surgery

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Myocardial Metabolis and Hemodynamic Responses with Isoflurane Anesthesia for Coronary Arterial Surgery

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

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