Performance of adjustable pressure‐limiting (<scp>APL</scp>) valves in two different modern anaesthesia machines

Thomas, Jörg; Weiß, Markus; Schmidt, Alexander R.; Buehler, Philipp K.

doi:10.1111/anae.13689

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…Inspired by Thomas et al. 's investigation of two adjustable pressure‐limiting (APL) valves , we conducted a basic evaluation of the APL valve in an Intersurgical Mapleson C circuit (Intersurgical, Wokingham, UK). There is little quantitative indication of the operational limiting pressure on the device, except an upper limit of ‘ P max 60 cm H 2 O’.…”

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confidence: 99%

Flow‐pressure characteristics of an Intersurgical adjustable pressure‐limiting valve

2017

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The adjusted difference in mean time for tracheal intubation was 60.9 (95% CI 20.5-101.3; p = 0.003) seconds faster in the videolaryngoscope group. We found no other statistically significant differences.Although this study lacks the statistical power to compare secondary outcomes between groups, we are confident that videolaryngocopy enables significantly faster tracheal intubation in bariatric patients with predicted difficult airways compared to fibreoptic bronchoscopy. It is unlikely that this resulted from differences in sedation or topical anesthesia, as the bispectral indices and airway reaction scores were comparable between the groups. We would welcome confirmation of our findings by other researchers.

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confidence: 99%

Flow‐pressure characteristics of an Intersurgical adjustable pressure‐limiting valve

2017

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“…It should be noted that most APL valves are not calibrated for pressure and the blow off pressure may alter between circuits and at different flow rates. 15,16 Use of pressure monitoring, with or without an APL valve, will allow control of airway pressure and should be considered either as a routine or selectively when caring for more vulnerable patients.…”

Section: For Inhalational Induction In An Uncooperative Childmentioning

confidence: 99%

“…When we discussed scavenging the addition of an APL valve was discussed and when describing the use in neonatal resuscitation the use of pressure monitoring was mentioned. It should be noted that most APL valves are not calibrated for pressure and the blow off pressure may alter between circuits and at different flow rates 15,16 . Use of pressure monitoring, with or without an APL valve, will allow control of airway pressure and should be considered either as a routine or selectively when caring for more vulnerable patients.…”

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Going around in circles. Is there a continuing need to use the T‐piece circuit in the practice of pediatric anesthesia?

Arnold

Kaufmann

2021

Pediatric Anesthesia

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Anesthetic equipment, including breathing circuits, has evolved over time. The T-piece circuit, in its various forms, was designed to meet the needs of its time. As equipment and techniques have moved on, it is timely to consider the place of the T-piece in modern pediatric anesthetic practice. Today the circle system is a ubiquitous part of anesthesia. When integrated with a modern anesthetic machine it offers precise control of ventilation together with continuous monitoring of airway pressure and flow: but at the cost of complexity. In comparison the T-piece offers a simple cheap lightweight design, so ergonomic in use that it almost becomes part of the anesthetist: but lacks the control and the barriers to unsafe use of more sophisticated systems. In addition, it requires high fresh gas flow adding to cost and environmental pollution. This pro-con debate discusses whether there remains a case for continuing to use the T-piece circuit in preference over other options. Possible indications for the T-Piece are discussed together with alternative strategies. The limitations of the circle system, the T-piece, and other alternative (such as self-inflating resuscitator bag) are discussed with respect to pediatric anesthetic practice. JK: When I finished medical school in 1997 and started my residency in anesthesiology, at the University Hospital of Cologne, I had my first and last contact with T-piece in anesthesia. Most of the operating theaters, including the ENT theater, were located in separate buildings. At that time, it was the usual procedure to transfer children still endotracheally intubated from theater to the postanesthetic care unit (PACU) and for extubation to be performed by PACU nursing staff. A "Kuhn-System," comparable to Jackson Rees System, was used during transfer and in PACU until extubation.

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“…We would like to clarify some important points arising from the editorial [1] and the GE healthcare response [2] to our article [3]. …”

Section: Apl Valvementioning

confidence: 99%

Flow‐pressure characteristics of a GE Healthcare Aisys CS²APL valve

Thomas

Weiß

2017

Anaesthesia

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Performance of adjustable pressure‐limiting (APL) valves in two different modern anaesthesia machines

Cited by 6 publications

References 13 publications

Flow‐pressure characteristics of an Intersurgical adjustable pressure‐limiting valve

Flow‐pressure characteristics of an Intersurgical adjustable pressure‐limiting valve

Going around in circles. Is there a continuing need to use the T‐piece circuit in the practice of pediatric anesthesia?

Flow‐pressure characteristics of a GE Healthcare Aisys CS²APL valve

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Performance of adjustable pressure‐limiting (APL) valves in two different modern anaesthesia machines

Cited by 6 publications

References 13 publications

Flow‐pressure characteristics of an Intersurgical adjustable pressure‐limiting valve

Flow‐pressure characteristics of an Intersurgical adjustable pressure‐limiting valve

Going around in circles. Is there a continuing need to use the T‐piece circuit in the practice of pediatric anesthesia?

Flow‐pressure characteristics of a GE Healthcare Aisys CS2APL valve

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Flow‐pressure characteristics of a GE Healthcare Aisys CS²APL valve