Cardiorespiratory effects of induction and maintenance of anesthesia with ketamine-midazolam combination, with and without prior administration of butorphanol or oxymorphone

Cardiorespiratory effects of an IV administered bolus of ketamine (7.5 mg/kg of body weight) and midazolam (0.375 mg/kg) followed by IV infusion of ketamine (200 micrograms/kg/min) and midazolam (10 micrograms/kg/min) for 60 minutes was determined in 6 dogs. Ketamine-midazolam combination was administered to dogs on 3 occasions to determine effects of prior administration of IV administered saline solution (1 ml), butorphanol (0.2 mg/kg), or oxymorphone (0.1 mg/kg). The infusion rate of ketamine and midazolam was decreased by 25% for anesthetic maintenance after opioid administration. There were no significant differences in cardiorespiratory variables after saline solution or butorphanol administration; however, oxymorphone caused significant (P < 0.05) increases in mean arterial blood pressure, systemic vascular resistance, and breathing rate. Bolus administration of ketamine-midazolam combination after saline solution caused significant (P < 0.05) increases in heart rate, mean arterial blood pressure, cardiac index, mean pulmonary blood pressure, venous admixture, and significant decreases in stroke index, pulmonary capillary wedge pressure, arterial and mixed venous oxygen tension, arterial oxygen content, and alveolar-arterial oxygen gradient. Opioid administration was associated with significantly (P < 0.05) lower values than was saline administration for heart rate, mean arterial blood pressure, and arterial and mixed venous pH and with higher values for stroke index, pulmonary capillary wedge pressure, and arterial and mixed venous carbon dioxide tension. Prior oxymorphone administration resulted in the highest (P < 0.05) values for mean pulmonary blood pressure, venous admixture, and arterial and mixed venous carbon dioxide tension, and the lowest values for arterial oxygen tension, and arterial and mixed venous pH. Each treatment provided otherwise uncomplicated anesthetic induction, maintenance, and recovery.(ABSTRACT TRUNCATED AT 250 WORDS)     

Middle ear gas composition in pathologic conditions: mass spectrometry in otitis media with effusion and atelectasis

It is generally assumed that the gas enclosed in the middle ear and mastoid air cell system is subject to continuous absorption, and that partial pressures for oxygen and carbon dioxide equal those of "mixed venous blood." We previously determined the concentrations in 10 adults with healthy ears by means of mass spectrometry. The results showed that the value for oxygen was in the expected range, but that the value for carbon dioxide was higher than in "mixed venous blood." The aim of the present investigation was to measure the gas concentrations with the same technique in diseased ears, to see if there are any differences in middle ear gases between healthy and diseased ears. In terms of group means, the present measurements in 13 ears of children with otitis media with effusion or atelectasis did not differ from the values previously obtained for healthy ears of adults for any of the gases.     

Respiratory gas exchange. Anesthesia with enflurane or isoflurane in nitrous oxide during spontaneous and controlled ventilation

The estimation of oxygen consumption and carbon dioxide elimination is essential for predicting the metabolic activity and needs of any patient having anaesthesia. During anaesthesia oxygen consumption can be measured and compared to a predicted value. However, oxygen uptake is affected by anaesthetic agents, which complicates the interpretation of measured oxygen uptake rate. The purpose of this study was to investigate whether there are any differences in respiratory gas exchange during anaesthesia with enflurane and isoflurane and also to assess the effects of spontaneous versus controlled ventilation. METHODS. Forty orthopedic patients were randomized to enflurane or isoflurane anaesthesia in nitrous oxide with either spontaneous or controlled ventilation. A fresh low-gas-flow technique was used. Inspiratory oxygen and end-tidal carbon dioxide concentrations and expiratory minute ventilation were measured in a circle absorber system between the y-piece and the endotracheal tube with a sampling analyser. Between the mixing box and the absorption canister, carbon dioxide concentration was continuously measured. The carbon dioxide elimination was calculated from mixed expired concentration and expiratory minute ventilation. Excess gas was collected every 10 min in a non-permeable mylar plastic bag connected to the excess valve. The excess gas flow was calculated and the oxygen uptake rate was assumed to be the difference between the oxygen fresh gas flow and the oxygen excess gas flow. RESULTS. The grand mean oxygen uptake rate was 2.5 ml.kg-1 x min-1 or 100 ml.min-1 x m-2. There were no statistically significant differences in oxygen uptake between enflurane and isoflurane anaesthesia or between spontaneous and controlled ventilation. The mean oxygen uptake rate at 10 min was between 2.0 and 2.2 ml.kg-1 x min-1 in all groups. At 30 min the mean oxygen uptake rates were 2.6 to 2.8 ml.kg-1 x min-1. Carbon dioxide elimination was closely associated with expired minute ventilation, with a carbon dioxide excretion of about 30 ml per litre gas exhaled, irrespective of ventilatory mode employed.     

Early markers of major adverse events in children after cardiac operations

OBJECTIVES: The purpose of this study was to determine the physiologic variables that predict major adverse events in children in the intensive care unit after cardiac operations. METHODS: A cohort observational study was conducted. At the time of admission to the intensive care unit and 4, 8, 12, and 24 hours later the following variables were recorded: mean arterial pressure, heart rate, cardiac index, oxygen delivery, mixed venous oxygen saturation, base deficit, blood lactate, gastric intramucosal pH, carbon dioxide difference (the difference between arterial carbon dioxide tension and gastric intraluminal carbon dioxide tension), and toe-core temperature gradient. Major adverse events were prospectively identified as cardiac arrest, need for emergency chest opening, development of multiple organ failure, and death. RESULTS: Ninety children were included in the study; 12 had major adverse events and there were 4 deaths. Blood lactate level, mean arterial pressure, and duration of cardiopulmonary bypass were the only significant, independent predictors of major adverse events when measured at the time of admission to the intensive care unit. The odds ratio (95% confidence intervals) for major adverse events if a lactate level was greater than 4.5 mmol/L was 5.1 (1.2 to 21.1), for admission hypotension 2.3 (0.5 to 9.8), and for a cardiopulmonary bypass time greater than 150 minutes 13.7 (3.3 to 57.2). Four hours after admission lactate and carbon dioxide difference, and 8 hours after admission lactate and base deficit, were independently significant predictors. The odds ratios for major adverse events if the blood lactate level was greater than 4 mmol/L at 4 and 8 hours were 8.3 (1.8 to 38.4) and 9.3 (1.9 to 44.3), respectively. At no time in the first 24 hours were cardiac output, oxygen delivery, mixed venous oxygen saturation, toe-core temperature gradient, or heart rate significant predictors of major adverse events. CONCLUSIONS: In the context of our current treatment strategies, the duration of cardiopulmonary bypass and blood lactate level, measured in the early postoperative period, were the best predictors of impending major adverse events.     

Theory of gas exchange in the avian parabronchus

To understand the distribution of oxygen and carbon dioxide in the avian lung, a theoretical treatment of gas exchange in the parabronchus of the avian lung is described. The model is modified after Zeuthen (1942). In addition to bulk flow through the parabronchial lumen, diffusion through the air spaces of both the parabronchial lumen and air capillaries is treated. The relationship of PO2 and PCO2 within the blood capillaries, air capillaries, and parabronchial lumen to parabronchial blood flow and ventilation is graphically shown. The results indicate that the variations of PO2 and PCO2 along an air capillary are less than one torr under resting conditions. Removal of diffusion resistance within the air space of the air capillaries increases calculated parabronchial gas exchange by less than 0.1% at rest. At high or resting ventilation rates the partial pressure profile along the parabronchial lumen calculated considering bulk flow only agrees well with the profile calculated considering bulk flow and axial diffusion, but as the ventilation rate decreases there is increasingly large disagreement. Forward diffusion of O2 toward the parabronchus reduces pre-parabronchial PO2 and backward diffusion of CO2 from the parabronchus increases PCO2. Neglecting diffusion within the air spaces of both the lumen and the air capillaries increases calculated parabronchial gas exchange by less than 2% (CO2) or 6% (O2) at rest.     

Transoesophageal echocardiographic assessment of haemodynamic function during laparoscopic cholecystectomy

We have measured cardiovascular changes associated with insufflation of carbon dioxide and the reverse Trendelenburg position during laparoscopic cholecystectomy, using transoesophageal echocardiography in 13 healthy patients. End-tidal carbon dioxide values increased after insufflation of carbon dioxide, with values significantly (P < 0.05) increased after lateral tilt positioning. Creation of a pneumoperitoneum was associated with increases (P < 0.05) in left ventricular end-systolic wall stress, concomitant with increases (P < 0.01) in peak airway pressure and systemic arterial pressure. In addition, left ventricular end-diastolic area decreased (P < 0.05) after reverse Trendelenburg positioning. Left ventricular ejection fraction was maintained throughout the study.     

Studies from the Department of Genetics at the New University of Lisbon, Portugal

Anaesthesia was induced in horses (n = 6) with a mixture of thiopentone and guaiphenesin and maintained by mechanical ventilation with a mixture of oxygen, air and isoflurane. Inspiratory and end-expiratory concentrations of oxygen, carbon dioxide and isoflurane were measured. Electrocardiography was used to evaluate heart rate and rhythm. Mean systemic arterial pressure (SAPm), pulmonary artery pressure (PAPm), right atrial pressure (RAPm) and pulmonary capillary wedge pressure (PCWP) were measured directly. Cardiac output was determined using the thermodilution method. Microcirculation in the upper triceps brachii muscle was estimated using laser Doppler flowmetry. Blood gas values, pH and haemoglobin concentration (Hb) were determined in arterial and mixed venous blood. Baseline values were taken after stabilisation of anaesthesia and were statistically compared to values obtained after an intravenous bolus of detomidine (10 micrograms/kg) had been injected at Time 0. Samples were then collected at 2, 10, 20, 30, 40 and 50 min. End-expiratory concentration of isoflurane was maintained at 1.8% during the experimental period described above. Thereafter, the isoflurane concentration was reduced to 1.3% and samples were collected at 60, 70 and 80 min. Detomidine caused a significant reduction of heart rate (HR), cardiac index (CI), oxygen transport (O2TR) and a significant elevation of the SAPm, systemic vascular resistance (SVR) and coefficient of utilisation of oxygen (O2CU) at 2 min. A significant reduction in HR, CI, SAPm, Hb, content of oxygen in arterial blood (CaO2) and O2TR and a significant elevation of O2CU were observed 10-50 min after the injection of detomidine. Reduction of the isoflurane end-expiratory concentration to 1.3% was followed by a progressive improvement of the SAPm, CI and muscle perfusion towards the baseline values. Further reduction of Hb and CaO2 as compared to the baseline values was observed during the period. The data suggest that detomidine potentiates some of the cardiovascular effects of isoflurane in horses.     

Dynamics of the process of gas transport into the body using a mathematical model

Dynamics of mass-transport of oxygen, carbon dioxide, and inert gases in lungs, blood, and tissues, as well as gas transport through alveolar capillary and erythrocyte membranes at rest and during exercise under normal and increased ambient pressures, were studied on a mathematical model. The model consists of 34 differential and 58 algebraic equations and makes it possible to estimate the dynamics of changes of over 90 parameters. The effect of various factors: duration of the respiratory cycle, tidal volume, airways resistance, the surface of diffusion, the resistance of alveolar-capillary wall, erythrocyte membrane, ventilation-perfusion relations, pulmonary blood shunts, blood supply to the tissues, Haldane and Verigo-Bohr effect, buffer capacity of the blood, and others) on the mass-transport of gases were quantitatively estimated.     

Arterial-venous carbon dioxide tension difference after hypothermic cardiopulmonary bypass

Arterial-venous carbon dioxide tension difference (Pv-aCO2) is known to become high after severe hemorrhage shock and resuscitation. We hypothesized that Pv-aCO2 might be high after cardiac surgery because of the oxygen debt occurred during hypothermic cardiopulmonary bypass (CPB). Blood pressure, cardiac index, hemoglobin, the arterial and mixed venous blood gases were repeatedly measured every 6 hours for 24 hours following cardiac surgery in 60 adult patients who underwent hypothermic CPB. Immediately after the surgery, Pv-aCO2 was extremely high, then gradually decreased to within normal ranges 12 hours later (8.0 +/- 2.9 mmHg vs 5.9 +/- 3.1 mmHg. p < 0.01). Factors which significantly correlated to Pv-aCO2 were cardiac index, oxygen delivery, minimum rectal temperature and duration of CPB. Oxygen debt during hypothermic CPB might cause significantly high Pv-aDO2. At least 12 hours were necessary to recover from anaerobic status to physiological condition.     

Alfentanil attenuates the cardiopulmonary response of critically ill patients to an acute increase in oxygen demand induced by chest physiotherapy

Critically ill patients often are subjected to interventions that acutely increase oxygen demand and require increased output of the cardiac and respiratory systems. This study explored whether alfentanil could attenuate the response to chest physical therapy, a procedure that increases oxygen consumption by 40%-50%. Patients were examined during two consecutive therapy sessions. In random order, they received either a placebo or alfentanil (30 or 60 micrograms/kg) 2 min before treatment. In Group 1 (n = 11, 30 micrograms/kg alfentanil) only the arterial blood pressure increases induced by chest physical therapy were attenuated. In Group 2 (n = 12, 60 micrograms/kg) alfentanil attenuated the increases in heart rate, central venous pressure, and pulmonary artery systolic pressures as well as systemic blood pressure. Neither dose of alfentanil altered the increases in oxygen consumption, carbon dioxide elimination, oxygen delivery, or extraction ratio. Thus alfentanil attenuated the hemodynamic responses to chest physiotherapy in a dose-dependent fashion. This was likely due to its vagotonic actions. In contrast, alfentanil had no effect on the balance between oxygen demand and delivery during chest physiotherapy. There was thus a dissociation between the hemodynamic and metabolic responses.     

氧气高炉回旋区内煤粉燃烧行为的三维数值模拟研究

炉顶煤气循环氧气高炉是一种全新的炼铁新工艺,它可以有效提高煤比、减少CO₂的排放.但是其复杂的燃烧条件将使煤粉在回旋区内的燃烧及高炉下部的行为发生很大变化.为了了解氧气高炉炼铁新工艺条件下喷吹煤粉的复杂现象,建立了一个氧气高炉条件下的氧煤枪-直吹管-风口-回旋区-焦炭床的三维数学模型,研究了氧气高炉下部的温度场、浓度场及煤粉的流动和燃烧特性.模拟结果表明,氧气高炉条件下的回旋区温度显著升高、高温区面积扩大,CO₂含量提高,焦炭床内CO含量显著增加.此外,与传统高炉相比,氧气高炉回旋区表面的煤粉燃尽率增加了10.24%.      

Use of jugular venous blood, compared with mixed venous blood, for measurement of venous oxygenation indices in a porcine model of endotoxic shock

OBJECTIVE: To evaluate the reliability of oxygen saturation and oxygen content values measured from jugular venous blood in estimating values measured from mixed venous blood during endotoxic shock. ANIMALS: 14 random-bred 10- to 15-kg Yorkshire pigs. PROCEDURE: 60 pairs of heparinized blood samples were simultaneously collected from the pulmonary artery and right jugular vein during an independent study, using a porcine model of endotoxic shock. Endotoxic shock was induced by infusion of Escherichia coli endotoxin. Eighteen of the sample pairs were obtained from pigs prior to infusion of endotoxin or from control pigs. Oxygen saturation and venous oxygen content were measured by direct oximetry. Analysis of bias and precision was used to compare jugular venous blood values with values obtained from mixed venous blood. Samples from endotoxemic pigs were subclassified on the basis of abnormal states of global oxygen imbalance associated with septic shock. RESULTS: Indices of venous oxygenation measured from jugular venous blood were an imprecise method of estimating values measured from mixed venous blood. There was no significant difference in bias between nonendotoxemic and endotoxemic pigs, regardless of abnormal hemodynamic states. CONCLUSION: Jugular venous blood oxygen saturation and oxygen content values should not be used to assess global oxygen transport during endotoxic shock.     

改性兰炭烟气SO2吸附材料的制备及其再生性能

利用活性炭（焦）等吸附剂将烟气中的污染物分离出来是一种有效的烟气治理与资源化方式。兰炭作为一种廉价半焦碳素材料,是一种有潜力代替现有商用活性焦的多孔材料。本文采用陕西兰炭作为研究对象,研究炭化时间、炭化温度、黏结剂添加量等改性工艺对所制备的吸附剂性能的影响,考察了微观形貌变化,利用X射线光电子能谱（XPS）探究在吸附解吸过程中的表面官能团的变化。结果表明,炭化温度对耐磨强度、耐压强度指标影响显著,炭化时间对饱和脱硫值和穿透脱硫值影响显著;在煤焦油添加比例50%,700 ℃炭化20 min,900 ℃活化60 min条件下制得改性兰炭参数为:耐磨强度95.81%,抗压强度536.1 N·cm?1,每克兰炭饱和脱硫值45.71 mg,每克兰炭穿透脱硫值23.45 mg;经历多次吸脱附过程第一次失活时,表面被大面积刻蚀,孔隙与小颗粒增多。兰炭吸附剂失活后可以通过二次活化的方式提高其吸附性能,但衰减速度比新改性兰炭要快。二次失活后,在酸蚀刻、水蒸气扩孔等共同作用下致使骨架结构过度烧蚀而坍塌;改性兰炭表面含氧基团的量和构成比例会影响吸附性能。含氧与含碳基团的比值与吸附性能相对应,含氧基团比例越高,吸附性能越差。二次活化再生改变了各含氧基团所占比例,令C=O显著下降,O?C=O显著增加,C?O变化不大。O?C=O官能团尽管含氧,但可能对吸附抑制作用不显著。本研究将为工业烟气治理提供一种新型吸附剂的制备方法,同时也为兰炭表面改性以及二氧化硫吸附解吸机制的研究提供参考。      

以阵列二氧化钛纳米棒为载体制备一体化析氧电极

以碳纸为支撑体,氯铱酸为前体,利用二氧化钛纳米棒阵列作为载体,采用浸渍-热分解法成功制备IrO₂-TiO₂/C一体化析氧电极.通过扫描电镜 (SEM)、XRD、XPS和电化学方法——循环伏安 (CV)、交流阻抗 (EIS) 等手段,研究载体形貌对析氧电极性能的影响.结果表明:二氧化钛载体能有效抑制支撑体碳纸在高电位下的腐蚀,当电压为2.4 V时,极化电流才仅为13.2 mA/cm2,一体化析氧电极积分电荷由87.2 mC/cm2增至178.5 mC/cm2,电极电化学反应阻抗由3.13 Ω·cm2降低到1.62 Ω·cm2,极大地提高了析氧电极的接触面积和催化剂的电催化活性.      

Comparative study on radiosensitivities of cultured cell lines derived from several human tumors under hypoxic condition

Three human cell lines, Burkitt lymphoma cells (P3HR-1), epidermoid carcinoma cells (HeLa S3-1), and melanoma cells (HMV) were irradiated with 200 kV X-rays under three different oxygen conditions. The values of D0 and D10(-2) were estimated for survival curves, and then the dose-modifying factors (DMF) were calculated, for the oxygenated and hypoxic irradiations. These DMF values for oxygenation were not different for each cell line, but those for hypoxia revealed considerable difference for cell lines. From the comparison of modifications due to variable oxygen concentrations on the survival curves of Burkitt lymphoma cells with those of other resistant cells, it is concluded that the shoulder of the survival curves becomes larger primarily with lowering of the oxygen tension, and then D0 value increases followed by a decrease in n value, while in oxygenation, the decrease in D0 value takes place after n value becomes close to 1.     

MR evaluation of developmental venous anomalies: medullary venous anatomy of venous angiomas

With continuous enhancement in oxygenator design, the question is raised as to how these changes actually impact the performance of the oxygenator. The recent addition of two new oxygenators by the Bentley Division of Baxter Healthcare Corporation provided us with a unique opportunity to compare the performance of each device and isolate the impact of each design change on performance. While the basic design and flow patterns have remained the same, application of the Duraflo II treatment has produced the Univox Gold and a change in the fibre-winding technique has produced the SpiralGold. This study compared the effects of heparin coating (Univox to Univox Gold) and fibre-winding (Univox Gold to SpiralGold) on gas and heat transfer and resistance to blood flow (pressure drop). Six oxygenators of each model were evaluated utilizing an in vitro single pass circuit, which first conditioned bovine blood to the Association for the Advancement of Medical Instrumentation (AAMI) venous standards. Blood flows of 4.0, 5.0, 6.0 and 7.0 l/min, FiO2 values of 1.0, 0.8 and 0.6, and gas-to-blood flow ratios of 0.5, 1.0 and 1.5 were chosen as test variables. Data generated included oxygen transfer, carbon dioxide transfer, arterial pO2, resistance to blood flow, and coefficient of heat exchange. The results indicate that the Duraflo II treatment does not have a significant effect on gas and heat transfer or resistance to blood flow. The fibre-winding technique employed with the new SpiralGold, however, has improved significantly gas exchange and arterial pO2 when compared with the previous Univox models. Resistance to blood flow and coefficient of heat exchange were not affected significantly by the winding technique.     

Comparison of disposable circle and 'to-and-fro' breathing systems during anaesthesia in dogs

Low-flow anaesthesia is beneficial in terms of reducing atmospheric pollution with waste anaesthetics and improving economy. This study compared a disposable circle and a 'to-and-fro' breathing system at low fresh gas flows (10 ml/kg/minute) in 19 dogs undergoing ovariohysterectomy. Ten dogs were assigned to the circle and nine to the to-and-fro breathing system. Fractional inspired halothane, end-tidal carbon dioxide and halothane were higher and mean blood pressure was lower in dogs using the to-and-fro system, possibly indicating an increased anaesthetic depth in this group. Use of both systems resulted in an elevated inspired carbon dioxide level, although this was significantly lower in the circle system. Further work will be required to determine the clinical relevance of this difference and whether rebreathing can be eliminated by higher fresh gas flows. The disposable circle studied may be used safely in dogs.     

Short-term effects of nasal proportional assist ventilation in patients with chronic hypercapnic respiratory insufficiency

Proportional assist ventilation (PAV) has recently been proposed as a mode of synchronized partial ventilatory support. This study evaluates the short-term effects of nasal PAV on arterial blood gases in stable patients with chronic hypercapnia. Forty two patients (30 with chronic obstructive pulmonary disease (COPD) and 12 with restrictive chest wall disease (RCWD) due to kyphoscoliosis) underwent a 1 h run of nasal PAV. Randomly, two levels of assistance were performed: 1) PAV was set at a level corresponding to volume assist (VA) and flow assist (FA) at 80% of the individual values of elastance (Ers) and resistance (Rrs) obtained with the "runaway" method; and 2) VA and FA were set at a value corresponding to the difference between the patients' individual Ers and Rrs and normal values of Ers and Rrs. Arterial blood gases and dyspnoea (by visual analogue scale (VAS)) were evaluated in all patients during unsupported ventilation and 60 min of PAV. PAV was well tolerated and resulted in significant improvement in arterial oxygen tension (Pa,O2), arterial carbon dioxide tension (Pa,CO2) (6.8+/-0.8 to 7.4+/-1.4 and 7.2/-0.9 to 6.8+/-0.9 kPa, respectively) and VAS (29+/-23 to 20+/-18%). The effects of PAV were not different in the two groups of diseases nor in the two groups of settings. Different settings of nasal proportional assist ventilation are well tolerated and may improve gas exchange and dyspnoea in patients with stable hypercapnic respiratory insufficiency.     

CO2顶吹比例对转炉终点控制的影响

结合CO₂的高温反应特性,针对性地制定了CO₂冶炼工艺,并对转炉顶吹CO₂比例对终点磷、氮和碳氧浓度积的影响进行了工业试验研究。结果表明:随着转炉冶炼前中期CO₂顶吹比例由4.84%逐渐提高到9.68%,转炉终点磷的质量分数先下降后基本不变,氮的质量分数逐渐下降,碳氧浓度积与渣中TFe变化趋势基本相同,均为先降低后增加,对于不同指标最佳顶吹CO₂比例不同。试验转炉终点磷、氮的质量分数、碳氧浓度积与渣中TFe均下降,下降比例最高分别为20.4%、34.3%、12.92%和8.89%。      

Effects of toborinone on systemic circulation in patients under general anesthesia

Patients with suppressed systemic circulation under general anesthesia received a 20-minute continuous infusion of toborinone at a rate of 5, 10, or 15 micrograms.kg-1.min-1, and the efficacy and safety of the drug were evaluated. Toborinone increased cardiac index (CI) and stroke volume index (SVI) dose-dependently, with significant increases at 10 and 15 micrograms.kg-1.min-1. An increase in CI was observed from 10 minutes after the start of infusion, with a return to the baseline value at 20-30 minutes after the completion of infusion. Toborinone did not affect heart rate at any dose tested, but the drug tended to decrease mean pulmonary arterial pressure, pulmonary capillary wedge pressure, and right atrial pressure. Mean arterial blood pressure tended to decrease after the start of infusion at all doses tested, and was significantly decreased at 20 minutes after the start of infusion at 10 and 15 micrograms.kg-1.min-1. Systemic vascular resistance and pulmonary vascular resistance decreased at all doses tested. T-wave amplitude on electrocardiaogram (ECG) and oxygen partial pressure in arterial blood decreased at 10 and 15 micrograms.kg-1.min-1. Toborinone increases cardiac output and decreases pre-load and after-load with no effects on heart rate, and, therefore, is thought to be a positive inotropic agent useful in the treatment of circulatory insufficiency. Due care should be exercised to monitor blood pressure, ECG, and arterial blood gas parameters of the patients. The effects of toborinone need to be further investigated in patients with complicated cardiac diseases under general anesthesia and in patients with circulatory insufficiency after surgery, including patients following extracorporeal circulation.