British Journal of Anaesthesia, 1993, Vol. 70, No. 3 333-338
© 1993 The Board of Management and Trustees of the British Journal of Anaesthesia
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INFLUENCE OF CARDIAC OUTPUT, INJECTION TIME AND INJECTION VOLUME ON THE INITIAL MIXING OF DRUGS WITH VENOUS BLOOD AFTER I.V. BOLUS ADMINISTRATION TO SHEEP
Department of Anaesthesia and Intensive Care, Royal Adelaide Hospital, University of Adelaide North Terrace, Adelaide, SA 5000, Australia
The aim of this study was to quantitate factors affecting the initial "peak " of the pulmonary artery (PA) drug concentrations after i.v. bolus drug administration, which is a determinant of the subsequent drug uptake into both the lungs and other well-perfused organs. Indocyanine green (ICG) was used as a marker drug in anaesthetized (1.5% halothane) sheep prepared with an inferior vena cava injection catheter and a large-gauge pulmonary artery blood sampling catheter. For three ranges of cardiac output, 2.5-mg doses of ICG were injected in the following combinations: 10ml injected over 1, 5 or 10 s; 5 or 25 ml injected over 1 s. On-line PA ICG concentrations were recorded for approximately 60s using a densitometer. The mean maximum PA ICG concentrations (2–8 mg litre-1), the mean times at which they occurred (7–18 s after injection) and the time lags before ICG was detected in the PA (4–9 s), were inversely related to cardiac output, but linearly related to the time over which the injection was made. The area under the curve of the peak was related inversely to cardiac output only, while the aspect ratio of the peak was related inversely to the time over which the injection was made only. The injectate volume had no effect on any of the measured values. We conclude that, in some circumstances, the rate of injection of drugs with narrow margins of safety should be tailored to the cardiac output of an individual. (Br. J. Anaesth. 1993; 70: 333–338)
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