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A1710
October 16, 2007 2:00 PM - 4:00 PM Room Hall D, Area L, |
| Online Measurement of Ethylene in Expiratory Air in Patients Undergoing Cardiopulmonary Bypass |
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Martin M. Schmoelz, M.D., Siegfried Praun, M.Sc., Ph.D., Michael Schmoeckel, M.D., Ph.D., Christian Kowalski, M.D., Gustav Schelling, M.D., Ph.D. Department of Anesthesiology, Ludwig Maximilians University, Munich, Bavaria, Germany |
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Introduction: Ethylene is a gaseous olefin which is ubiquitous in the environment and is produced in plants, mammals and humans. Uptake of exogenous ethylene occurs mostly via inhalation. Ethylene is biotransformed to ethylene oxide, which is also an important volatile industrial chemical. This epoxide forms hydroxyethyl adducts with haemoglobin and DNA and is mutagenic in vivo and in vitro and carcinogenic in experimental animals1. In addition, a comparative study showed that inhalation of ethylene oxide lead to cell death of embryonic pulmonary epithelial cells2. Here we show that ethylene is released during cardiac surgery from cardiopulmonary bypass (CPB) and can be detected and measured using online mass-spectrometry in expiratory air. Methods: We used a mass spectrometry system based on ion-molecule reactions coupled with quadrupole mass spectrometry (IMR-MS) which provides a highly-sensitive method for on-line and off-line measurements of organic and inorganic compounds in gasesa/3. The IMR-MS system was directly connected to patients (n=7) undergoing cardiac surgery via a T-piece inserted between the endotracheal tube and the Y-connector of the anesthesia machine. Airway gas was continuously sampled at 50 ml/min. We analyzed ethylene counts before CPB, during extracorporeal circulation and after CPB and used isoprene (an ubiquitous compound in exhaled breath) measured simultaneously as a control substance. During CPB, patients were ventilated at a respiratory rate of 10/min and at a tidal volume of 300 ml which resulted in an estimated minimal alveolar ventilation of about 2.5 l/min. Results: Ethylene signalling in expiratory air increased significantly, while isoprene counts decreased significantly during CPB as compared to pre-CPB and post-CPB values (p < 0.001, RM-ANOVA) (Figure). Conclusion: IMR-MS allows the breath-to-breath analyses of expiratory air during major surgery. Ethylene is most likely released from materials and membranes of the CBP circuit but may also result from lipid peroxidation of omega-3 polyunsaturated fatty acids during ischemia-reperfusion4. More research regarding the true source and biologic activity of volatile hydrocarbons during CPB is needed. 1 Toxicol.Appl.Pharmacol. 2000; 165: 1-26 2 Toxicol.Lett. 1994; 70: 23-32 3 Anesthesiology 2007; 106:665-674 4 Free Radical Biol Med 1994, 17 (2) 127-160 aAirsense Mass Spectrometry System, V&F medical development GmbH, A-6067 Absam, Austria.[figure1] Anesthesiology 2007; 107: A1710 |
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