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

2020 ◽  
Author(s):  
Martin Bellgardt ◽  
Dominik Drees ◽  
Vladimir Vinnikov ◽  
Adrian I. Georgevici ◽  
Livia Procopiuc ◽  
...  
Keyword(s):  
Gas Flow ◽  
Care Setting ◽  
Lung Model ◽  
Breathing System ◽  
Gas Flows ◽  
Test Lung ◽  
In Vitro Performance ◽  
Volume Controlled ◽  
Circle Breathing System

AbstractTo 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.

scholarly journals 47. Comparison of Devices Used While Ventilating a Non-Intubated Mannikin Model

1996 ◽  
Vol 11 (S2) ◽  
pp. S43-S43
Author(s):  
Glenn Updike ◽  
Vince Mosesso ◽  
Tom Auble
Keyword(s):  
Repeated Measures ◽  
Mechanical Test ◽  
Calculated Data ◽  
Minute Volume ◽  
Lung Model ◽  
Emergency Medical Technicians ◽  
Test Lung ◽  
Convenience Sample ◽  
Multiple Comparison Test

Purpose: The purpose of this study was to determine if there were differences in tidal volume (Vt), minute volume (MV), average mask leak per breath (ML), gastric insufflation (GI), and peak airway pressure (PAP) when ventilating a non-intubated mannikin with a bag-valve (BV), manually triggered ventilator (MTV) and automated ventilator (AV). Our hypothesis was that there would be no differences among devices for any of these variables.Methods: This was a prospective in vitro experimental model. A convenience sample of 19 emergency medical technicians (EMTs) ventilated a non-intubated mannikin-mechanical test lung model with BV, MTV (flow rate 40 L/min; pressure relief 55 cm H2O), and AV (800 ml/breath; rate 12). Each subject, blinded to volume and pressure gauges, used each device for two minutes at both normal (0.1 cm H2O) and poor (0.04 cm H2O) compliances. Vt, MV, GI, and PAP were measured directly and ML was calculated. Data were analyzed with repeated measures ANOVA and Bonferoni-Dunn multiple comparison test with alpha set at 0.05.

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

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 389 ◽  
Author(s):  
Petter Jakobsson ◽  
Madleine Lindgren ◽  
Jan G. Jakobsson
Keyword(s):  
Gas Flow ◽  
Anaesthetic Machine ◽  
Flow Time ◽  
Lung Model ◽  
Low Flow ◽  
Major Influence ◽  
Test Lung ◽  
Depth Of Anaesthesia ◽  
Low Flow Anaesthesia ◽  
End Tidal

Background:Modern anaesthesia workstations are reassuringly tight and are equipped with effective gas monitoring, thus providing good opportunities for low/minimal flow anaesthesia. A prerequisite for effective low flow anaesthesia is the possibility to rapidly increase and decrease gas concentrations in the circle system, thereby controlling the depth of anaesthesia. Methods:We studied the wash-in and wash-out of sevoflurane in the circle system with fixed fresh gas flow and vaporizer setting. We compared two modern anaesthesia work stations, the Aisys (GE, Madison, WI, USA) and FLOW-i (Maquet, Solna, Sweden) in a test lung model. Results: We found fresh-gas flow to have, as expected, a major influence on wash-in, as well as wash-out of sevoflurane. The wash-in time to reach a stable circle 1 MAC (2.1%) decreased from an average of 547 ± 83 seconds with a constant fresh gas flow of 300 ml/min and vaporizer setting of 8%, to a mean of 38 ± 6 seconds at a fresh gas flow of 4 L/min. There were only minor differences between the two works-stations tested; the Aisys was slightly faster at both 300 and 4 L/min flow. Time to further increase circle end-tidal concentration from 1-1.5 MAC showed likewise significant associations to fresh gas and decreased from 330 ± 24 seconds at 300 ml/min. to less than a minute at constant 4 L/min (17 ± 11 seconds), without anaesthetic machine difference. Wash-out was also fresh gas flow dependent and plateaued at 7.5 L/min. Conclusions: Circle system wash-in and wash-out show clear fresh gas dependency and varies somewhat between the Aisys and Flow-i. The circle saturation, reaching 1 MAC end-tidal or increasing from 1-1.5 MAC can be achieved with both work-stations within 1.5 minutes at a constant fresh gas flow of 2 and 4 L/min. Wash-out plateaued at 7.5 L/min.

scholarly journals Pre-oxygenation in pregnancy: the effect of fresh gas flow rates within a circle breathing system

Anaesthesia ◽  
2008 ◽  
Vol 63 (8) ◽  
pp. 833-836 ◽  
Author(s):  
E. C. Russell ◽  
I. Wrench ◽  
M. Feast ◽  
F. Mohammed
Keyword(s):  
Gas Flow ◽  
Breathing System ◽  
Flow Rates ◽  
Circle Breathing System ◽  
In Pregnancy

In-vitro performance of a low flow extracorporeal carbon dioxide removal circuit

Perfusion ◽  
2019 ◽  
Vol 35 (3) ◽  
pp. 227-235 ◽  
Author(s):  
Nicholas A Barrett ◽  
Nicholas Hart ◽  
Luigi Camporota
Keyword(s):  
Carbon Dioxide ◽  
Gas Exchange ◽  
Gas Flow ◽  
Blood Gases ◽  
Low Flow ◽  
Bench Test ◽  
Gas Flows ◽  
In Series

Introduction: Extracorporeal gas exchange requires the passage of oxygen and carbon dioxide (CO2) across an artificial membrane. Current European Union regulations do not require the transfer to be assessed in models using clinically relevant haemoglobin, making it difficult for clinicians to understand the CO2 clearance of a membrane, and how it changes in relation to sweep gas flow through the membrane. The characteristics of membrane CO2 clearance are described using a single membrane at different sweep gas flows in an in vitro model with clinically relevant haemoglobin concentrations using three separate methods of calculating CO2 clearance. Methods: To define the CO2 removal characteristics of the extra-corporeal CO2 removal (ECCO2R) device, we devised an in-vitro gas exchange circuit formed by a dedicated ECCO2R circuit (ALung, Pittsburgh, USA) in series with two membrane oxygenators. The system was primed with donated expired human red cells provided by the local blood bank. The experimental set-up allowed constant CO2 input (via one membrane oxygenator) with variable removal from a portion of the blood in a manner which was analogous to that seen in vivo. Blood gases were measured from different ports in the circuit in order to measure the experimental membrane CO2 clearance (VCO2). Results: Results demonstrate that the relationship between VCO2 and gas flow at a constant blood flow of 0.4 L/minute with a haemoglobin of 7 g/dL increases sharply from a gas flow of 0 to 2 L/min but plateaus at gas flows >4 L/minute. VCO2, calculated using three different methods, showed a strong linear correlation with minimal bias. Conclusions: The CO2 clearance of the membrane used in this bench test is non-linear. This has implications for clinical practice, especially during the weaning phase of the device.

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

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 389 ◽  
Author(s):  
Petter Jakobsson ◽  
Madleine Lindgren ◽  
Jan G. Jakobsson
Keyword(s):  
Gas Flow ◽  
Anaesthetic Machine ◽  
Flow Time ◽  
Lung Model ◽  
Low Flow ◽  
Major Influence ◽  
Test Lung ◽  
Depth Of Anaesthesia ◽  
Low Flow Anaesthesia ◽  
End Tidal

Background:Modern anaesthesia workstations are reassuringly tight and are equipped with effective gas monitoring, thus providing good opportunities for low/minimal flow anaesthesia. A prerequisite for effective low flow anaesthesia is the possibility to rapidly increase and decrease gas concentrations in the circle system, thereby controlling the depth of anaesthesia. Methods:We studied the wash-in and wash-out of sevoflurane in the circle system with fixed fresh gas flow and vaporizer setting. We compared two modern anaesthesia work stations, the Aisys (GE, Madison, WI, USA) and FLOW-i (Maquet, Solna, Sweden) in a test lung model. Results: We found fresh-gas flow to have, as expected, a major influence on wash-in, as well as wash-out of sevoflurane. The wash-in time to reach a stable circle 1 MAC (2.1%) decreased from an average of 547 ± 83 seconds with a constant fresh gas flow of 300 ml/min and vaporizer setting of 8%, to a mean of 38 ± 6 seconds at a fresh gas flow of 4 L/min. There were only minor differences between the two works-stations tested; the Aisys was slightly faster at both 300 and 4 L/min flow. Time to further increase circle end-tidal concentration from 1-1.5 MAC showed likewise significant associations to fresh gas and decreased from 330 ± 24 seconds at 300 ml/L to less than a minute at constant 4 L/min (17 ± 11 seconds), without anaesthetic machine difference. Wash-out was also fresh gas flow dependent and plateaued at 7.5 L/min. Conclusions: Circle system wash-in and wash-out show clear fresh gas dependency and varies somewhat between the Aisys and Flow-i. The circle saturation, reaching 1 MAC end-tidal or increasing from 1-1.5 MAC can be achieved with both work-stations within 1.5 minutes at a constant fresh gas flow of 2 and 4 L/min. Wash-out plateaued at 7.5 L/min.

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