In vitro performance evaluation of AnaConDaTM-100 and AnaConDaTM-50 compared to a circle breathing system for control and consumption of volatile anaesthetics

Abstract

To identify the better volatile anaesthetic delivery system in an intensive care setting, we compared the circle breathing system and two models of reflection systems (AnaConDa™ with a dead space of 100 ml (ACD-100) or 50 ml (ACD-50)). These systems were analysed for the parameters like wash-in, consumption, and wash-out of isoflurane and sevoflurane utilising a test lung model. The test lung was connected to a respirator (circle breathing system: Aisys CS™; ACD-100/50: Puriton Bennett 840). Set parameters were volume-controlled mode, tidal volume-500 ml, respiratory rate-10/min, inspiration time-2 sec, PEEP-5 mbar, and oxygen-21%. Wash-in, consumption, and wash-out were investigated at fresh gas flows of 0.5, 1.0, 2.5, and 5.0 l/min. Anaesthetic target concentrations were 0.5, 1.0, 1.5, 2.0, and 2.5%. Wash-in was slower in ACD-100/-50 compared to the circle breathing system, except for fresh gas flows of 0.5 and 1.0 l/min. The consumption of isoflurane and sevoflurane in ACD-100 and ACD-50 corresponded to the fresh gas flow of 0.5-1.0 l/min in the circle breathing system. Consumption with ACD-50 was higher in comparison to ACD-100, especially at gas concentrations > 1.5%. Wash-out was quicker in ACD-100/-50 than in the circle breathing system at a fresh gas flow of 0.5 l/min, however, it was longer at all the other flow rates. Wash-out was comparable in ACD-100 and ACD-50. Wash-in and wash-out were generally quicker with the circle breathing system than in ACD-100/-50. However, consumption at 0.5 minimum alveolar concentration was comparable at flows of 0.5 and 1.0 l/min.

Inhaliacinių Anestetikų Panaudojimo Intensyviojoje Terapijoje Galimybės

“…"Sedaconda ACD-L" prietaisas pasižymi didesniu efektyvumu, mažesniu anestetiko sunaudojimu, greitesniu inhaliacinio anestetiko įsotinimu teikiant didesnes inhaliacinio anestetiko dozes (sevoflurano/izoflurano konc. iškvėptame ore >1,5-2 %) [22]. Anestetikus tausojantis prietaisas neturi elektroninių komponentų, todėl yra saugus naudoti atliekant magnetinio rezonanso tomografijos ir kompiuterinės tomografijos tyrimus [15].…”

“…Inhaliacinių anestetikų panaudojimas ITS vis dar kelia nemažai diskusinių klausimų. Tyrimai neretai atliekami laboratorijose griežtai kontroliuojamomis sąlygomis, dėl to sunku nuspėti, ar gauti rezultatai būtų panašūs realiomis sąlygomis [21,22,40].…”