title: The young lamb can increase cardiovascular performance during isoflurane anesthesia.
abstract: Cardiac output and myocardial blood flow decrease dramatically in a dose-dependent pattern in the young lamb during isoflurane anesthesia. This raises important questions about the ability of the young lamb to increase myocardial performance if oxygen delivery were compromised by a decrease in oxygen content during anesthesia and surgery. To investigate the ability of the young lamb to increase oxygen delivery during isoflurane anesthesia, the response to hypoxemia, which is known to increase myocardial performance, was studied in awake 1-week-old lambs. Mean systemic arterial pressure, heart rate, cardiac output, and regional distribution of blood flow were measured during three states: awake, 1.0 minimum alveolar concentration (MAC) of isoflurane in an FIO2 of 1.0, and 1.0 MAC of isoflurane in an FIO2 of 0.09. Stroke volume, total body and myocardial oxygen consumption, and fractional extraction of oxygen were calculated for the total body and for the myocardium. Isoflurane anesthesia decreased mean systemic arterial pressure (70 +/- 8 mmHg), heart rate (222 +/- 29 beats/min), and cardiac output (277 +/- 72 ml.kg-1.min-1) significantly (43 +/- 11 mmHg, 163 +/- 20 beats/min, 191 +/- 34 ml.kg-1.min-1). Hypoxemia returned heart rate to control (191 +/- 23 beats/min), increased stroke volume (1.71 +/- 0.2 ml/kg) above both control (1.23 +/- 0.2 ml/kg) and 1.0 MAC isoflurane levels (1.19 +/- 0.3 ml/kg), and increased cardiac output (325 +/- 61 ml.kg-1.min-1) above the level during 1.0 MAC isoflurane.
authors.affiliation: Department of Anesthesia, University of California, San Francisco 94143-0648.
authors.forename: C M
authors.initials: CM
authors.lastname: Brett
authors.forename: D F
authors.initials: DF
authors.lastname: Teitel
authors.forename: M A
authors.initials: MA
authors.lastname: Heymann
authors.forename: A M
authors.initials: AM
authors.lastname: Rudolph
mesh_terms: D000768:Anesthesia, General; D000818:Animals; D000831:Animals, Newborn; D002320:Cardiovascular Physiological Phenomena; D003326:Coronary Circulation; D006439:Hemodynamics; D007530:Isoflurane; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption; D012756:Sheep
chemical_list: D007530:Isoflurane