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Exhaled propofol

John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
Dandan Jiang, Enyou Li, Qinghua Zhou, Xin Wang, Hanwei Li, Bangyu Ju, Lei Guo, Desheng Liu, Haiyang Li
Online monitoring of exhaled propofol concentration is important for anesthetists to provide adequate anesthesia as propofol concentrations in plasma and breath are correlated reasonably well. Exhaled propofol could be detected by 63Ni ion mobility spectrometry in negative ion mode, however, the radioactivity of 63Ni source restricts its clinical application due to safety, environmental, and regulatory concerns. An acetone-assisted negative photoionization ion mobility spectrometer (AANP-IMS) using a side-mounted vacuum ultraviolet (VUV) lamp in the unidirectional (UD) flow mode was developed for sensitively measurement of exhaled propofol by producing high percentage of O2-(H2O)n...
March 23, 2018: Analytical Chemistry
Fengjiang Zhang, Hao Dong, Xuanlang Zhang, Jin Guo, Yunqing Liu, Cheng Zhou, Xi Zhang, Jun Liu, Min Yan, Xing Chen
Propofol (2,6-diisopropylphenol) is widely used in total intravenous anesthesia. An unknown drug concentration in blood always leads to some side effects in patients with propofol injection. However, the drug concentration in the blood is hard to be continuously measured since invasive sampling causes a loss of blood at each measurement. Here, we introduced a virtual surface acoustic wave sensor array (VSAWSA) to non-invasively detect the propofol concentration in blood through exhaled gases. Calibration was conducted by a parallel test using gas chromatography and mass spectrometry (GC-MS) with solid-phase micro-extraction (SPME) for preconcentration...
2017: Analytical Sciences: the International Journal of the Japan Society for Analytical Chemistry
Felix Maurer, Larissa Walter, Martin Geiger, Jörg Ingo Baumbach, Daniel I Sessler, Thomas Volk, Sascha Kreuer
Propofol is a commonly used intravenous general anesthetic. Multi-capillary column (MCC) coupled Ion-mobility spectrometry (IMS) can be used to quantify exhaled propofol, and thus estimate plasma drug concentration. Here, we present results of the calibration and analytical validation of a MCC/IMS pre-market prototype for propofol quantification in exhaled air. Calibration with a reference gas generator yielded an R2 ≥0.99 with a linear array for the calibration curve from 0 to 20 ppbv . The limit of quantification was 0...
October 25, 2017: Journal of Pharmaceutical and Biomedical Analysis
Felix Maurer, Martin Geiger, Thomas Volk, Daniel I Sessler, Sascha Kreuer
Plasma concentrations of intravenous drugs cannot currently be evaluated in real time to guide clinical dosing. However, a system for estimating plasma concentration of the anesthetic propofol from exhaled breath may soon be available. Developing reliable calibration and analytical validation techniques is thus necessary. We therefore compared the established sorbent tube liquid injection technique with a gas injection procedure using a reference gas generator. We then quantified propofol with Tenax sorbent tubes in combination with gas-chromatography coupled mass spectrometry in the breath of 15 patients (101 measurements)...
September 5, 2017: Journal of Pharmaceutical and Biomedical Analysis
Hao Dong, Feng Jiang Zhang, Fu Yuan Wang, Ying Ying Wang, Jing Guo, G M Kanhar, Jing Chen, Jun Liu, Chen Zhou, Min Yan, Xing Chen
In balanced anesthesia, sevoflurane and propofol are often used in combination to achieve a better anesthetic effect. However, methods for on-line monitoring of concentrations of the two anesthetics in patients are still rare in clinical. This study proposed a non-invasive method utilizing a fast gas chromatograph combined with a surface acoustic wave sensor (Fast GC-SAW) to simultaneously on-line monitor sevoflurane and propofol in patients' exhaled gas. By using the direct resistive heating capillary column, the single detection time of Fast GC-SAW system was significantly shortened to 90s, as well as the size reduced to (40cm×30cm×20cm)...
July 14, 2017: Journal of Chromatography. A
Phillip Trefz, Svend Kamysek, Patricia Fuchs, Pritam Sukul, Jochen K Schubert, Wolfram Miekisch
Breath analysis not only holds great potential for the development of new non-invasive diagnostic methods, but also for the identification and follow up of drug levels in breath. This is of interest for both, forensic and medical science. On the one hand, the detection of drugs of abuse in exhaled breath-similar to the well-known breath alcohol tests-would be highly desirable as an alternative to blood or urine analysis in situations such as police controls for drugged driving. The non-invasive detection of drugs and their metabolites is thus of great interest in forensic science, especially since marijuana is becoming legalized in certain parts of the US and the EU...
March 20, 2017: Journal of Breath Research
F Maurer, D J Lorenz, G Pielsticker, T Volk, D I Sessler, J I Baumbach, S Kreuer
Propofol is an intravenous anesthetic. Currently, it is not possible to routinely measure blood concentration of the drug in real time. However, multi-capillary column ion-mobility spectrometry of exhaled gas can estimate blood propofol concentration. Unfortunately, adhesion of volatile propofol on plastic materials complicates measurements. Therefore, it is necessary to consider the extent to which volatile propofol adheres to various plastics used in sampling tubing. Perfluoralkoxy (PFA), polytetrafluorethylene (PTFE), polyurethane (PUR), silicone, and Tygon tubing were investigated in an experimental setting using a calibration gas generator (HovaCAL)...
January 23, 2017: Journal of Breath Research
Johanna M M van Breugel, Joost W Wijlemans, Hermanus H B Vaessen, Martijn de Greef, Chrit T W Moonen, Maurice A A J van den Bosch, Mario G Ries
BACKGROUND: Previous studies demonstrated both pre-clinically and clinically the feasibility of magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablations in the liver. To overcome the associated problem of respiratory motion of the ablation area, general anesthesia (GA) and mechanical ventilation was used in conjunction with either respiratory-gated energy delivery or energy delivery during induced apnea. However, clinical procedures requiring GA are generally associated with increased mortality, morbidity, and complication rate compared to procedural sedation and analgesia (PSA)...
2016: Journal of Therapeutic Ultrasound
Pieter Colin, Douglas J Eleveld, Johannes P van den Berg, Hugo E M Vereecke, Michel M R F Struys, Gustav Schelling, Christian C Apfel, Cyrill Hornuss
INTRODUCTION: Monitoring of drug concentrations in breathing gas is routinely being used to individualize drug dosing for the inhalation anesthetics. For intravenous anesthetics however, no decisive evidence in favor of breath concentration monitoring has been presented up until now. At the same time, questions remain with respect to the performance of currently used plasma pharmacokinetic models implemented in target-controlled infusion systems. In this study, we investigate whether breath monitoring of propofol could improve the predictive performance of currently applied, target-controlled infusion models...
July 2016: Clinical Pharmacokinetics
H Gudziol, R Gottschall, D Geil, H Lehnich, T Bitter, O Guntinas-Lichius
BACKGROUND: The affective valence of an olfactory stimulus will be encoded in its respiratory response. Unpleasant odors shorten the inhalation of the first stimulated breaths in wakefulness and sleep. The aim of the present study was to assess the effekt of intravenous anesthetic propofol on the chemosensory evoked changes of breathing pattern. MATERIAL AND METHODS: 13 ASA 1/2 patients got intranasal chemosensory stimuli (H2S and CO2) by flow-olfactometer during "deep" (EEG-based bispectral analysis, BIS:≤60) and "moderate" (BIS>60) propofol-induced sedation with preserved spontaneous breathing...
June 2016: Laryngo- Rhino- Otologie
J Obermeier, P Trefz, K Wex, B Sabel, J K Schubert, W Miekisch
Bulky and hyphenated laboratory-based analytical instrumentation such as gas chromatography/mass spectrometry is still required to trace breath biomarkers in the low ppbV level. Innovative sensor-based technologies could provide on-site and point-of-care (POC) detection of volatile biomarkers such as breath aldehydes related to oxidative stress and cancer. An electrochemical sensor system was developed for direct detection of the total abundance of aldehydes in exhaled breath in the ppbV level and for simultaneous determination of the airway inflammation markers carbon monoxide (CO) and nitric oxide (NO)...
March 2015: Journal of Breath Research
Y Liu, Y Gong, C Wang, X Wang, Q Zhou, D Wang, L Guo, X Pi, X Zhang, S Luo, H Li, E Li
BACKGROUND: Breath analysis of propofol is a potential noninvasive method for approximating the plasma propofol concentration. There have been various reported techniques for measuring the exhaled propofol concentration at steady state; however, the propofol concentration undergoes marked changes during clinical anesthesia. Therefore, this study investigated the use of membrane inlet-ion mobility spectrometry (MI-IMS) to monitor exhaled propofol discontinuously and continuously during propofol anesthesia...
March 2015: Acta Anaesthesiologica Scandinavica
Qinghua Zhou, Enyou Li, Zhenxin Wang, Yulei Gong, Changsong Wang, Lei Guo, Haiyang Li
Based on the adsorption of analytes in the sampling loop, a time-resolved dynamic dilution introduction method was developed for negative ion mobility spectrometry to continuously monitor end-tidal propofol without other sample pre-separation. The dynamic dilution characteristics of propofol and moisture in the Teflon sample loop (4 mm o.d. and 2.4 mm i.d., 150 cm length) were both theoretically and experimentally investigated. The prominent absorption differences between propofol and moisture on the inwall of the sample loop allowed their concentrations to be time-resolved during the injection process, realizing sensitive measurement of end-tidal propofol with a response time of 2 s...
March 2015: Journal of Breath Research
Seok Young Song, Jin Yong Jung, Min-Su Cho, Jong Hae Kim, Tae Ha Ryu, Bong Il Kim
BACKGROUND: The purpose of this study was to investigate the changes in airway pressure and arterial oxygenation between ventilation modes during one-lung ventilation (OLV) in patients undergoing thoracic surgery. METHODS: We enrolled 27 patients for thoracic surgery with OLV in the lateral decubitus position. The subjects received various modes of ventilation in random sequences during surgery, including volume-controlled ventilation (VCV) and pressure-controlled ventilation-volume guaranteed (PCV-VG) with a tidal volume (TV) of 8 ml/kg of actual body weight...
October 2014: Korean Journal of Anesthesiology
Qinghua Zhou, Lei Hua, Changsong Wang, Enyou Li, Haiyang Li
On-line monitoring of propofol in exhaled air is a potential way to evaluate the anaesthesia depth for patients during surgery. In this study, a negative (63)Ni ionization high resolution ion mobility spectrometer with Bradbury-Nielsen-Gate-Grid structure was built to measure propofol with reactant ions Cl(-)(H2O) n using dichloromethane as dopant. Instead of forming three propofol ions (M - H)(-), M · O2(-), and (M2 - H)(-) with reactant ions O2(-)(H2O)n, only product ion M · Cl(-) was produced when introducing dichloromethane gas...
January 2015: Journal of the American Society for Mass Spectrometry
X Chen, X L Zhang, L Liu, Y Chen, M Y Piao, F J Zhang, W D Wu, Y B Zhong, K Sun, Y C Zou, X Zhang, D Wang, P Wang, M Yan
BACKGROUND: Although pilot studies have reported that exhaled propofol concentrations can reflect intraoperative plasma propofol concentrations in an individual, the blood/exhaled partial pressure ratio RBE varies between patients, and the relevant factors have not yet been clearly addressed. No efficient method has been reported for the quick evaluation of RBE and its association with inter-individual variables. METHODS: We proposed a novel method that uses a surface acoustic wave (SAW) sensor combined with a fast gas chromatograph (GC) to simultaneously detect propofol concentrations in blood and exhaled gas in 28 patients who were receiving propofol i...
November 2014: British Journal of Anaesthesia
S Kreuer, A Hauschild, T Fink, J I Baumbach, S Maddula, Th Volk
Online measurement of drug concentrations in patient's breath is a promising approach for individualized dosage. A direct transfer from breath- to blood-concentrations is not possible. Measured exhaled concentrations are following the blood-concentration with a delay in non-steady-state situations. Therefore, it is necessary to integrate the breath-concentration into a pharmacological model. Two different approaches for pharmacokinetic modelling are presented. Usually a 3-compartment model is used for pharmacokinetic calculations of blood concentrations...
2014: Scientific Reports
Anton Amann, Ben de Lacy Costello, Wolfram Miekisch, Jochen Schubert, Bogusław Buszewski, Joachim Pleil, Norman Ratcliffe, Terence Risby
Breath analysis is a young field of research with its roots in antiquity. Antoine Lavoisier discovered carbon dioxide in exhaled breath during the period 1777-1783, Wilhelm (Vilém) Petters discovered acetone in breath in 1857 and Johannes Müller reported the first quantitative measurements of acetone in 1898. A recent review reported 1765 volatile compounds appearing in exhaled breath, skin emanations, urine, saliva, human breast milk, blood and feces. For a large number of compounds, real-time analysis of exhaled breath or skin emanations has been performed, e...
September 2014: Journal of Breath Research
Kim van Loon, Aart T van Rheineck Leyssius, Bas van Zaane, Mirjam Denteneer, Cor J Kalkman
BACKGROUND: Propofol, a short-acting hypnotic drug, is increasingly administered by a diverse group of specialists (e.g., cardiologists, gastroenterologists) during diagnostic and therapeutic procedures. Standard monitoring during sedation comprises continuous pulse oximetry with visual assessment of the patient's breathing pattern. Because undetected hypoventilation is a common pathway for complications, capnographic monitoring of exhaled carbon dioxide has been advocated. We examined whether the use of capnography reduces the incidence of hypoxemia during nonanesthesiologist-administered propofol sedation in patients who did not receive supplemental oxygen routinely...
July 2014: Anesthesia and Analgesia
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