Preparation of anaesthesia workstation for trigger-free anaesthesia
| Autor: | Nils Dennhardt, Robert Sümpelmann, Christian Thoben, Stefan Zimmermann, Sebastian Heiderich, H. Rüffert, Terence Krauß |
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| Rok vydání: | 2019 |
| Předmět: |
Sevoflurane
law.invention 03 medical and health sciences Desflurane 0302 clinical medicine 030202 anesthesiology law medicine Humans business.industry Outcome measures Washout 030208 emergency & critical care medicine Fresh gas flow Anesthesiology and Pain Medicine Activated charcoal Charcoal Anesthesia Anesthetics Inhalation Ventilation (architecture) Equipment Contamination Anesthesia Inhalation Malignant Hyperthermia business Minimal flow medicine.drug |
| Zdroj: | European Journal of Anaesthesiology. 36:851-856 |
| ISSN: | 0265-0215 |
| Popis: | BACKGROUND Trigger-free anaesthesia is required for patients who are susceptible to malignant hyperthermia. Therefore, all trace of volatile anaesthetics should be removed from anaesthetic machines before induction of anaesthesia. Because the washout procedure is time consuming, activated charcoal filters have been introduced, but never tested under minimal flow conditions. OBJECTIVE To investigate performance of activated charcoal filters during long duration (24 h) simulated ventilation. DESIGN A bench study. SETTING A Primus anaesthesia machine (Drager) was contaminated with either 4% sevoflurane or 8% desflurane by ventilating a test lung for 90 min. The machine was briefly flushed according to manufacturer instructions, activated charcoal filters were inserted and a test lung was ventilated in a 24 h test. Trace gas concentrations were measured using a closed gas loop high-resolution ion mobility spectrometer with gas chromatographic preseparation. During the experiment reduced fresh gas flows were tested. At the end of each experiment the activated charcoal filters were removed and the machine was set to standby for 10 min to test for residual contamination within the circuit. The activated charcoal filters were reconnected into the circuit to test their ability to continue removing volatile anaesthetics (functional test) from the gas. Control experiments were conducted without activated charcoal filters. MAIN OUTCOME MEASURES Absolute concentrations of desflurane and sevoflurane. RESULTS The concentration of volatile anaesthetics dropped to less than 5 ppm (parts per million) following insertion of activated charcoal filters. In the desflurane experiments at least 1 l min FGF was needed to keep the concentration below an acceptable level ( |
| Databáze: | OpenAIRE |
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