Turlapaty et all reviewed the pharmacology, pharmacokinetics, and perioperative applications of nicardipine. They suggested the potential use of nicardipine in place of other vasodilators in patients undergoing anesthesia and surgery. Considering the possible use of nicardipine in patients undergoing cardiopulmonary bypass (CPB), it is of note that nicardipine produced a marked transfer of intravascular fluid and plasma albumin out of the vascular compartment in anesthetized rats.? Accordingly, peripheral edema may be associated with chronic use of calcium antagonists.' Cardiac surgical patients undergoing CPB are predisposed to generalized edema. Therefore, the possible extravasation-increasing effect of nicardipine and other calcium channel blockers should be considered in these patients to avoid any further fluid efflux to the extravascular space. Interestingly, hemoconcentration by an extrarenal mechanism has also been observed with atrial natriuretic factor (ANF), another arteriolar dilator.v" This raises the possibility that transcapillary shift of vascular components might be related to vasodilation. However, doubt for this view is cast by the observation that a hypotensive dose of sodium nitroprusside did not affect hematocrit and plasma volume, whereas ANF did." Therefore, when replacing conventional vasodilators with new ones!" in CPB patients, the possible increased edema with these drugs should be kept in mind. Further studies are needed before definite conclusions can be reached.