Fentanyl sequestration in lungs during cardiopulmonary bypass

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Abstract
Serum fentanyl [an anesthetic] concentrations were measured before, during and after cardiopulmonary bypass and correlated with changes in total protein, albumin, hematocrit, pH and PCO2 [CO2 partial pressure] in 5 patients undergoing cardiac surgery. Serum fentanyl concentrations, total protein, albumin and hematocrit declined with initiation of bypass but remained unchanged thereafter. PCO2 and pH did not change. In an additional 7 patients, simultaneous pulmonary-artery and radial-artery fentanyl concentrations were measured. During bypass, when little, if any, blood flowed through the pulmonary circulation, pulmonary artery fentanyl concentrations were higher than systemic arterial concentrations, but when lung ventilation and perfusion were restored, radial artery concentrations rose and pulmonary artery concentrations fell, indicating fentanyl sequestration in the lungs during bypass.

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