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British Journal of Anaesthesia, 2000, Vol. 84, No. 5 565-570
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigation

Inspired oxygen fraction after cardiopulmonary bypass: effects on pulmonary function with regard to endothelin-1 concentrations and venous admixture

A. Reber1, B. Budmiger1, M. Wenk2, W. E. Haefeli2, T. Wolff3, T. Bein4 and K. Skarvan1

1 Department of Anaesthesia, University of Basel/Kantonsspital, CH-4031 Basel, Switzerland.
2 Department of Clinical Pharmacology, University of Basel/Kantonsspital, CH-4031 Basel, Switzerland.
3 Department of Cardiothoracic Surgery, University of Basel/Kantonsspital, CH-4031 Basel, Switzerland.
4 Department of Anaesthesiology, University Hospital, D-93042 Regensburg, Germany

A. Reber, Department of Anaesthesia, University of Basel/Kantonsspital, CH-4031 Basel, Switzerland.

Twenty consecutive patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were allocated at random to group 1 (n=10, high inspired oxygen fraction (FO2) after CPB), or group 2 (n=10, moderate FO2 after CPB). The effects of each FO2 on arterial and mixed venous concentrations of endothelin-1 (ET-1) and its precursor, Big ET-1, were measured. Venous admixture was calculated to assess the efficiency of pulmonary gas exchange. Patients whose lungs had been ventilated with a FO2 of 1.0 (exposure time 70 min) after weaning from the CPB machine had significantly greater arterial and mixed venous Big ET-1 concentrations and venous admixture than patients whose lungs were ventilated with a FO2 of 0.35. In contrast, ET-1 concentrations in the two groups were not significantly different. A reduction of FO2 from 1.0 to 0.6 reduced venous admixture without lowering endothelial peptide concentrations. On the first postoperative day all peptide concentrations were similar in the two groups, whereas venous admixture remained non-significantly higher in group 1. A short period of high FO2 immediately after CPB increases endothelin concentrations and pulmonary venous admixture.


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