Xenon alters right ventricular function

• Published in: Acta anaesthesiologica Scandinavica 2008-09, Vol.52 (8), p.1056-1063
• Main Authors: HEIN, M., BAUMERT, J. H., ROEHL, A. B., PASCH, L., SCHNOOR, J., COBURN, M., ROSSAINT, R.
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Female; Hemodynamics - drug effects; Medical sciences; right ventricular function; Swine; Ventricular Function, Right - drug effects; volumetric swan ganz catheter; xenon; Xenon - pharmacology
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.2008.01696.x

Background: In contrast to other volatile anesthetics, xenon produces less cardiovascular depression with fewer fluctuations of various hemodynamic parameters, but reduces cardiac output (CO) in vivo. Besides an increase in left ventricular afterload and reduction of heart rate, an impairment of the right ventricular function might be an additional pathophysiological mechanism for the reduction of CO. Therefore, we used an animal model to study the effects of xenon as a supplemental anesthetic on right ventricular function, especially right ventricular afterload. Methods: Right ventricular function was monitored with a volumetric pulmonary artery catheter in 11 pigs during general anesthesia with thiopental. Six animals received additional 70% (volume) xenon (equivalent to 0.55 MAC minimum alveolar concentration). Parameters for systolic function, afterload, and preload were calculated at baseline and during 50 min of xenon application, and in a corresponding control group. Significant differences were detected by multivariate analyses of variance for repeated measures. Results: Xenon reduced CO on average by 30% and increased pulmonary arterial elastance by 60%, which led to a reduction of the right ventricular ejection fraction by 25%. Whereas right ventricular preload remained stable, maximal slope of pulmonary artery pressure and the right ventricular elastance increased. No effect on the ratio of stroke work and end‐diastolic volume was found. Conclusion: The reduction in CO during xenon anesthesia was partly due to an impairment of the right ventricular function, mainly caused by an increased afterload, without an impairment of systolic ventricular function.