ECC interferes with the pharmacokinetics and pharmacodynamics of drugs through several phenomena: haemodilution, hypothermia, tissue sequestration, changes in organ flow, lung isolation, depulsing, absorption by plastics, changes in protein binding by heparin, metabolic changes, systemic inflammatory response [2]; for halogens: changes in blood/gas partition coefficient, changes in solubility, passage of oxygenator membranes [1]. These effects are variable depending on the substance and temperature; the clinical translation is the result of the various changes (Table 7.4).
© CHASSOT PG, GRONCHI F, April 2008, last update, December 2019
References
BARRY AE, CHANEY MA, LONDON MJ. Anaesthetic management during cardiopulmonary bypass: a systematic review. Anesth Analg 2015; 120:749-69
HALL RI. Cardiopulmonary bypass and the systemic inflammatory response: Effects on drug actions. J Cardiothorac Vasc Anesth 2002; 16:83-98