Simple assay of plasma sevoflurane and its metabolite hexafluoroisopropanol by headspace GC–MS

Bourdeaux, Daniel; Sautou, V.; Montagner, Agnès; Parratte, Sébastien; Constantin, Jean Michel; Bazin, Jean-Étienne; Chopineau, J.

doi:10.1016/j.jchromb.2009.11.018

Cited by 15 publications

(11 citation statements)

References 18 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a previous pilot randomized controlled trial of patients with moderate to severe ARDS, inhaled sevoflurane, compared to intravenous midazolam, improved oxygenation and decreased inflammation and lung epithelial injury, as assessed by plasma and an alveolar soluble receptor for advanced glycation end-products (sRAGE), interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF)-α [ 14 ]. In this study and others [ 15 , 16 , 17 ], sevoflurane inhalation through dedicated devices was well tolerated, with no major adverse effects [ 18 ]. This pilot trial was underpowered to evaluate mortality or other major clinical outcomes.…”

Section: Introductionsupporting

confidence: 60%

Design and Rationale of the Sevoflurane for Sedation in Acute Respiratory Distress Syndrome (SESAR) Randomized Controlled Trial

Blondonnet

Simand

Vidal

et al. 2022

JCM

Self Cite

View full text Add to dashboard Cite

Preclinical studies have shown that volatile anesthetics may have beneficial effects on injured lungs, and pilot clinical data support improved arterial oxygenation, attenuated inflammation, and decreased lung epithelial injury in patients with acute respiratory distress syndrome (ARDS) receiving inhaled sevoflurane compared to intravenous midazolam. Whether sevoflurane is effective in improving clinical outcomes among patients with ARDS is unknown, and the benefits and risks of inhaled sedation in ARDS require further evaluation. Here, we describe the SESAR (Sevoflurane for Sedation in ARDS) trial designed to address this question. SESAR is a two-arm, investigator-initiated, multicenter, prospective, randomized, stratified, parallel-group clinical trial with blinded outcome assessment designed to test the efficacy of sedation with sevoflurane compared to intravenous propofol in patients with moderate to severe ARDS. The primary outcome is the number of days alive and off the ventilator at 28 days, considering death as a competing event, and the key secondary outcome is 90 day survival. The planned enrollment is 700 adult participants at 37 French academic and non-academic centers. Safety and long-term outcomes will be evaluated, and biomarker measurements will help better understand mechanisms of action. The trial is funded by the French Ministry of Health, the European Society of Anaesthesiology, and Sedana Medical.

show abstract

Section: Introductionsupporting

confidence: 60%

Design and Rationale of the Sevoflurane for Sedation in Acute Respiratory Distress Syndrome (SESAR) Randomized Controlled Trial

Blondonnet

Simand

Vidal

et al. 2022

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…These subjects were nominally healthy non-smokers with normal indexes for liver and renal function who underwent elective surgeries with a 3 h SEV anesthesia. Blood concentrations of SEV and HFIP were estimated from graphs and literature [17,27]. They are reported in table 1 using the original units of μM in plasma and the expected concentrations (our estimate) in exhaled breath.…”

Section: Empirical Data From Literature: Amentioning

confidence: 99%

“…However, 1752-7155/13/036001+10$33.00 Table 1. Literature values and unit conversion for SEV uptake and elimination and HFIP produced from Kharasch et al [17] and Bourdeaux et al [27].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Post-operative elimination of sevoflurane anesthetic and hexafluoroisopropanol metabolite in exhaled breath: pharmacokinetic models for assessing liver function

Ghimenti¹,

Francesco²,

Onor³

et al. 2013

J. Breath Res.

View full text Add to dashboard Cite

Sevoflurane (SEV), a commonly used anesthetic agent for invasive surgery, is directly eliminated via exhaled breath and indirectly by metabolic conversion to inorganic fluoride and hexafluoroisopropanol (HFIP), which is also eliminated in the breath. We studied the post-operative elimination of SEV and HFIP of six patients that had undergone a variety of surgeries lasting between 2.5 to 8.5 h using exhaled breath analysis. A classical three compartments pharmacokinetic model developed for the study of environmental contaminants was fitted to the breath data. We found that SEV kinetic behavior following surgery (for up to six days) is consistent across all subjects whereas the production and elimination of HFIP varies to some extent. We developed subject specific parameters for HFIP metabolism and interpreted the differences in the context of timing and dose of anesthesia, type of surgery, and specific host factors. We propose methods for assessing individual patient liver function using SEV as a probe molecule for assessing efficiency of liver metabolism to HFIP. This work is valuable not only for the clinical study of metabolism recovery, but potentially also for the study of the interaction of other manufactured and environmental compounds with human systems biology in controlled exposure and observational studies.

show abstract

“…When FGF ¼ MV, FI will go up to (and stabilize at) FD because the exhaled TV is not part of the next inhaled TV after the circuit is filled with the FD of sevoflurane gas, provided that the atmospheric pressure and the temperature difference between the patient's body and the operating room are all constant. All of the inhaled sevoflurane is equal to the sum of the volume that is dissolved in blood 9 and tissue fluid, bound with proteins in plasma and tissue fluid, metabolized by the liver, ejected by the kidneys, 10,11 shed through blood loss and dispersed through the raw operating surface and skin. Once FI is equal to FD and stable, F A , F a and F t will be stable when the volume of sevoflurane ejected through the nonrespiratory tract route (i.e.…”

Section: Discussionmentioning

confidence: 99%

Establishing the relationship between FGF/MV and FI/FD, and determining the saturation state of sevoflurane anaesthesia during the induction phase and factors affecting nonrespiratory tract ejection volume

Zhiyang

2013

J Int Med Res

View full text Add to dashboard Cite

Objectives: To investigate (i) the relationship between the ratio of fresh gas flow to min volume (FGF/MV) and the ratio of the fraction of inspired sevoflurane to the delivered concentration of sevoflurane (FI/FD); (ii) to establish the saturation state of sevoflurane anaesthesia and factors affecting the volume of ejected sevoflurane through the nonrespiratory tract route (nVERT) during the saturation state. Methods: Two studies were undertaken in patients with cancer, scheduled to undergo surgery. All patients received tracheal intubation and inhaled sevoflurane. In study 1, anaesthesia parameters were fixed, the initial FD of sevoflurane was 2.2% vol and the FGF/MV was set to 0.2, 0.3, 0.4 and 1.0 in groups A, B, C and D, respectively. In study 2, FGF ¼ MV and the initial FD of sevoflurane was 2.2% vol, but the tidal volume (TV) was set to 6, 8 or 10 ml/kg in groups I, II and III, respectively. Results: Study 1 (n ¼ 60) showed a positive relationship between FI/FD and FGF/MV. In study 2

show abstract

Simple assay of plasma sevoflurane and its metabolite hexafluoroisopropanol by headspace GC–MS

Cited by 15 publications

References 18 publications

Design and Rationale of the Sevoflurane for Sedation in Acute Respiratory Distress Syndrome (SESAR) Randomized Controlled Trial

Design and Rationale of the Sevoflurane for Sedation in Acute Respiratory Distress Syndrome (SESAR) Randomized Controlled Trial

Post-operative elimination of sevoflurane anesthetic and hexafluoroisopropanol metabolite in exhaled breath: pharmacokinetic models for assessing liver function

Establishing the relationship between FGF/MV and FI/FD, and determining the saturation state of sevoflurane anaesthesia during the induction phase and factors affecting nonrespiratory tract ejection volume

Contact Info

Product

Resources

About