Volumetric and reflective device dead space of anaesthetic reflectors under different conditions.

Inhalation sedation is increasingly performed in intensive care units. For this purpose, two anaesthetic reflectors, AnaConDa™ and Mirus™ are commercially available. However, their internal volume (100 ml) and possible carbon dioxide reflection raised concerns. Therefore, we compared carbon dioxide...

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Publicado en:Journal of Clinical Monitoring & Computing Vol. 32; no. 6; pp. 1073 - 1081
Autores principales: Bomberg, Hagen, Veddeler, Max, Volk, Thomas, Groesdonk, Heinrich V., Meiser, Andreas
Formato: research Journal Article
Publicado: Springer Nature Dec2018
Acceso en línea:Ver este registro en EBSCOhost
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      place: New York, New York
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        atl: Volumetric and reflective device dead space of anaesthetic reflectors under different conditions.
      aug:
        au:
          Bomberg, Hagen
          Veddeler, Max
          Volk, Thomas
          Groesdonk, Heinrich V.
          Meiser, Andreas
        affil: Department of Anaesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Medical Centre, University of Saarland, Kirrbergerstrasse 1, 66421, Homburg, Saarland, Germany
      sug:
        subj:
          Respiratory Dead Space Physiology
          Anesthesia, Inhalation Equipment and Supplies
          Tidal Volume
          Anesthesia, Inhalation Statistics and Numerical Data
          Respiration, Artificial Statistics and Numerical Data
          Respiration, Artificial Equipment and Supplies
          Intensive Care Units
          Carbon Dioxide Metabolism
          Anesthetics, Inhalation Administration and Dosage
          Lung Metabolism
          Models, Biological
          Human
          Monitoring, Physiologic Statistics and Numerical Data
          Isoflurane Administration and Dosage
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Clinical Assessment Tools
      ab: Inhalation sedation is increasingly performed in intensive care units. For this purpose, two anaesthetic reflectors, AnaConDa™ and Mirus™ are commercially available. However, their internal volume (100 ml) and possible carbon dioxide reflection raised concerns. Therefore, we compared carbon dioxide elimination of both with a heat moisture exchanger (HME, 35 ml) in a test lung model. A constant flow of carbon dioxide was insufflated into the test lung, ventilated with 500 ml, 10 breaths per minute. HME, MIRUS and AnaConDa were connected successively. Inspired (insp-CO2) and end-tidal carbon dioxide concentrations (et-CO2) were measured under four conditions: ambient temperature pressure (ATP), body temperature pressure saturated (BTPS), BTPS with 0.4 Vol% (ISO-0.4), and 1.2 Vol% isoflurane (ISO-1.2). Tidal volume increase to maintain normocapnia was also determined. Insp-CO2 was higher with AnaConDa compared to MIRUS and higher under ATP compared to BTPS. Isoflurane further decreased insp-CO2 and abolished the difference between AnaConDa and MIRUS. Et-CO2 showed similar effects. In addition to volumetric dead space, reflective dead space was determined as 198 ± 6/58 ± 6/35 ± 0/25 ± 0 ml under ATP/BTPS/ISO-0.4/ISO-1.2 conditions for AnaConDa, and 92 ± 6/25 ± 0/25 ± 0/25 ± 0 ml under the same conditions for MIRUS, respectively. Under BTPS conditions and with the use of moderate inhaled agent concentrations, reflective dead space is small and similar between the two devices.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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