Wash-in and wash-out of sevoflurane in a test-lung model: A comparison between Aisys and FLOW-i

Jakobsson, Petter; Lindgren, Madleine; Jakobsson, Jan

doi:10.12688/f1000research.11255.2

Cited by 11 publications

(9 citation statements)

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“…Data showed that the time to reach the target concentration did not depend on the FGF in the circle breathing system. At first instance, this observation seems unusual because flow-dependent wash-in times have been described for different anaesthetic machines by prior researchers and this further corresponds to the perception of anaesthetists in clinical practice [5,6]. However, it is known that the Aisys CS™ anaesthesia ventilator with the VA-specific Aladin™ cassette controls the VA output independent of the manually adjusted FGF.…”

Section: Discussionmentioning

confidence: 80%

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

Bellgardt

Drees

Vinnikov

et al. 2020

J Clin Monit Comput

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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.

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Section: Discussionmentioning

confidence: 80%

“…An anaesthesia gas scavenging system is connected (5). The circle breathing system is connected via a heat moisture exchanger (6) to the test lung box with two bag-valve units (BV) with a volume of 2 l each. b ACD.…”

Section: Experimental Settingmentioning

confidence: 99%

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

Bellgardt

Drees

Vinnikov

et al. 2020

J Clin Monit Comput

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“…and a F V S of 8%. They found that the F A S reached 1 MAC (2.1%) at 547 ± 83 and 38 ± 6 sec, respectively [5]. Leijonhufvud [12].…”

Section: Jakobsson Et Al Reported a Wash-in In A Test-lung Model Witmentioning

confidence: 98%

1-1-8 one-step sevoflurane wash-in scheme for low-flow anesthesia: simple, rapid, and predictable induction

Tribuddharat

Sathitkarnmanee

Vattanasiriporn

et al. 2019

Preprint

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Background Sevoflurane is suitable for low-flow anesthesia (LFA). LFA needs a wash-in phase. The reported sevoflurane wash-in schemes lack simplicity, target coverage, and applicability. We proposed a one-step 1-1-8 wash-in scheme for sevoflurane LFA to be used with both N 2 O and Air. The objective of our study was to identify time for achieving each level of alveolar concentration of sevoflurane (F A S) from 1% to 3.5% in both contexts.Methods We recruited 199 adults requiring general anesthesia with endotracheal intubation and controlled ventilation—102 in group N 2 O and 97 in group Air. After induction and intubation, a wash-in was started using a fresh gas flow of O 2 :N 2 O or O 2 :Air at 1:1 L·min -1 plus sevoflurane 8%. The ventilation was controlled to maintain end-tidal CO 2 of 30-35 mmHg.Results The rising patterns of F A S and inspired concentration of sevoflurane (F I S) are similar, running parallel between the groups. The F A S/F I S ratio increased from 0.46 to 0.72 within 260 sec in group N 2 O and from 0.42 to 0.69 within 286 sec in group Air. The respective time to achieve an F A S of 1%, 1.5%, 2%, 2.5%, 3%, and 3.5% was 1, 1.5, 2, 3, 3.5, and 4.5 min in group N 2 O and 1, 1.5, 2, 3, 4, and 5 min in group Air. The heart rate and blood pressure of both groups significantly increased initially then gradually decreased as F A S increased.Conclusions The 1-1-8 wash-in scheme for sevoflurane LFA has many advantages, including simplicity, coverage, swiftness, safety, economy, and that it can be used with both N 2 O and Air. A respective F A S of 1%, 1.5%, 2%, 2.5%, 3%, and 3.5% when used with N 2 O and Air can be expected at 1, 1.5, 2, 3, 3.5, and 4.5 min and 1, 1.5, 2, 3, 4, and 5 min. This scheme may be applied for sevoflurane LFA in situations where an anesthetic gas analyzer is unavailable.

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“…Thus, the target of F A S during anesthesia in daily practice varies between 1 to 3.5%, depending on the adjuvant drugs used. A good wash-in scheme should be able to precisely and promptly achieve every target of F A S. There are a few reports regarding wash-in schemes of sevoflurane LFA but those studies achieved only one or two targets of F A S [3][4][5]. In highly developed healthcare areas-where an anesthetic gas monitor is placed in every operating theatre-a wash-in scheme would be unnecessary.…”

Section: Introductionmentioning

confidence: 99%

1-1-8 one-step sevoflurane wash-in scheme for low-flow anesthesia: simple, rapid, and predictable induction

et al. 2020

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Background: Sevoflurane is suitable for low-flow anesthesia (LFA). LFA needs a wash-in phase. The reported sevoflurane wash-in schemes lack simplicity, target coverage, and applicability. We proposed a one-step 1-1-8 washin scheme for sevoflurane LFA to be used with both N 2 O and Air. The objective of our study was to identify time for achieving each level of alveolar concentration of sevoflurane (F A S) from 1 to 3.5% in both contexts. Methods: We recruited 199 adults requiring general anesthesia with endotracheal intubation and controlled ventilation-102 in group N 2 O and 97 in group Air. After induction and intubation, a wash-in was started using a fresh gas flow of O 2 :N 2 O or O 2 :Air at 1:1 L•min − 1 plus sevoflurane 8%. The ventilation was controlled to maintain end-tidal CO 2 of 30-35 mmHg. Results: The rising patterns of F A S and inspired concentration of sevoflurane (F I S) are similar, running parallel between the groups. The F A S/F I S ratio increased from 0.46 to 0.72 within 260 s in group N 2 O and from 0.42 to 0.69 within 286 s in group Air. The respective time to achieve an F A S of 1, 1.5, 2, 2.5, 3, and 3.5% was 1, 1.5, 2, 3, 3.5, and 4.5 min in group N 2 O and 1, 1.5, 2, 3, 4, and 5 min in group Air. The heart rate and blood pressure of both groups significantly increased initially then gradually decreased as F A S increased. Conclusions: The 1-1-8 wash-in scheme for sevoflurane LFA has many advantages, including simplicity, coverage, swiftness, safety, economy, and that it can be used with both N 2 O and Air.

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Wash-in and wash-out of sevoflurane in a test-lung model: A comparison between Aisys and FLOW-i

Cited by 11 publications

References 10 publications

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

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

1-1-8 one-step sevoflurane wash-in scheme for low-flow anesthesia: simple, rapid, and predictable induction

1-1-8 one-step sevoflurane wash-in scheme for low-flow anesthesia: simple, rapid, and predictable induction

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