Document Detail


An evaluation of the contributions by fresh gas flow rate, carbon dioxide concentration and desflurane partial pressure to carbon monoxide concentration during low fresh gas flows to a circle anaesthetic breathing system.
MedLine Citation:
PMID:  18339215     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Numerous in vitro studies have shown that volatile anaesthetics react with desiccated carbon dioxide (CO2) absorbents to produce carbon monoxide (CO). The effects of anaesthetic concentration, fresh gas flow rate, and the hydration of absorbent or the excretion of CO2 by patients on CO production have also been investigated. This work aims to identify the most significant one of these factors on CO concentration in a low-flow anaesthesia system, without control of the hydration of the absorbents. METHODS: A simulated clinical circle anaesthetic breathing system was used to study the CO concentration under various conditions. Desflurane was used at three different concentrations. Two CO2 flow rates and three fresh gas flow rates were used. The absorbent temperatures and hydration were measured simultaneously. RESULTS: Desflurane degraded to produce CO in the breathing tube, when the CO2 absorbents were not dried beforehand. In this imitation clinical low-flow setting, fresh gas flow affected the CO production more than the CO2 did (31.7% vs. 9.5%). The actual desflurane partial pressure was not a significant factor. The CO2 flow rate explained 18.2% and 54.0% of the variation of the absorbent hydration changes (%) and temperature, respectively. CONCLUSIONS: In clinical practice, the CO2 production varies among patients and is uncontrollable, but markedly affects CO production. The only controllable factor is the fresh gas flow rate if the ultimate goal is to reduce the undesirable exposure of patients to CO from the breathing tube according to this bench model without counting the oxygen consumption.
Authors:
S-Z Fan; Y-W Lin; W-S Chang; C-S Tang
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-03-13
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  25     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-01     Completed Date:  2008-08-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  620-6     Citation Subset:  IM    
Affiliation:
National Taiwan University, College of Medicine, Department of Anesthesiology, Taiwan, ROC.
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MeSH Terms
Descriptor/Qualifier:
Absorption
Anesthesia, Closed-Circuit*
Anesthetics, Inhalation / chemistry*
Carbon Dioxide / chemistry*
Carbon Monoxide / analysis*
Humidity
Isoflurane / analogs & derivatives*,  chemistry
Oxygen / metabolism
Partial Pressure
Regression Analysis
Temperature
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 124-38-9/Carbon Dioxide; 26675-46-7/Isoflurane; 57041-67-5/desflurane; 630-08-0/Carbon Monoxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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