Pharmacokinetics of Diazepam and Midazolam When Used for Sedation Following Cardiopulmonary Bypass

Lowry, K. G.; Dundee, John W.; McClean, E.; Lyons, Seán; Carson, Ian; Orr, I. A.

doi:10.1093/bja/57.9.883

Cited by 22 publications

(2 citation statements)

References 12 publications

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“…Lack of cumulation with intermittent bolus administration has been reported in a group of adult patients following cardiac surgery (Lowry et aL, 1985). If the clearance values in paediatric patients were similar to those previously measured in adults (Klotz and Reimann, 1984), plasma concentrations of between 200 and 850 ng ml" 1 would be expected from the infusion rates used in these children.…”

Section: Discussionmentioning

confidence: 62%

Infusion of Midazolam in Paediatric Patients After Cardiac Surgery

Lloyd-Thomas¹,

Booker²

1986

British Journal of Anaesthesia

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Midazolam was given, by infusion, for the sedation of 10 children receiving intensive care after cardiac surgery. Plasma concentrations greater than 250 ng ml-1 were required for adequate sedation. Midazolam did not cumulate in eight of the 10 children, and these patients excreted the drug in a fashion similar to that by adults. However, midazolam did accumulate in two children, one with profound hepatic disturbance. In one of these patients recovery was slow following cessation of the infusion.

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Section: Discussionmentioning

confidence: 62%

Infusion of Midazolam in Paediatric Patients After Cardiac Surgery

Lloyd-Thomas¹,

Booker²

1986

British Journal of Anaesthesia

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“…212 Propofol reduces CMR02 and CBF in a dose-dependent manner without affecting cerebral autoregulation. 215 cause of these cerebral effects and other desirable pharmacokinetic and pharmodynamic characteristics of propofol, several studies have assessed the potential of propofol to provide cerebroprotection during ischemia. 215 cause of these cerebral effects and other desirable pharmacokinetic and pharmodynamic characteristics of propofol, several studies have assessed the potential of propofol to provide cerebroprotection during ischemia.…”

Section: Propojolmentioning

confidence: 99%

Cardiopulmonary Bypass

1995

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Th is book aims at providing an 'easily readable source of material for the everyday practice of clinical perfusion' . Th e information included should interest both newcomers to perfusion and also more experienced perfusion ists, anesthesiologists and surgeons.Th is 207-pages work includes 15 chapters, is well illustrated and contains a lot of tables and interesting diagrams. Th e fi rst chapters present the equipment and the preparation of the cardiopulmonary bypass (CPB) circuit, the conduct of the bypass and the process of weaning from mechanical to physiological circulation. Two chapters describe the management of the hemostatic and metabolic consequences of the CPB circuit. One chapter is dedicated to myocardial protection. Th e eff ects of extracorporeal circulation on the body are described, with particular attention to the brain and the kidney, two organs at high risk of complication after CPB. Mechanical circulatory support, deep hypothermic circulatory arrest and extracorporeal membrane oxygenation are described in specifi c chapters. Th e last chapter describes CPB in noncardiac procedures, such as thoracic aortic surgery, pulmonary embolism, hepatic and pulmonary trans plantation, major oncologic surgery, and trauma. Th e editors and authors are UK and US anesthetists, perfusionists and surgeons with recognized expertise in the fi eld of CPB.Th is book covers most of the topics related to the management of CPB -in adults. Unfortunately, there is no chapter dealing specifi cally with pediatric CPB.Th e information provided in this book is relatively basic, and is less complete than in many textbooks on the subject. Several chapters refer to relatively old concepts of perfusion that have been challenged since (that is, the use of crystalloids as the priming fl uid, management of the on-bypass hematocrit on bypass, overview of the coagulation cascade, and so forth). Little information is provided about new perfusion approaches such as the Heart Port ® technique, the mini-bypass technique, the diff erent coating options of the bypass circuitry, the diff erent mechanical circulatory support devices, and so forth. In this fi eld, the more recent strategies are not described.Each chapter ends with suggested further reading that most often includes other reference books or relatively old articles, which do not really represent the actual trends in clinical perfusion.In conclusion, while this book should interest both newcomers and experienced perfusionists, it does not fully meet its objectives -sometimes being incomplete and sometimes being too basic.Abbreviations CPB, cardiopulmonary bypass.

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