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

European Journal of Anaesthesiology

Volumn 25, Issue 8, 2008, Pages 620-626

  Fan, S Z ^a   Lin, Y W ^b   Chang, W S ^a   Tang, C S ^b  

^a NATIONAL TAIWAN UNIVERSITY   (Taiwan)

^b FU JEN CATHOLIC UNIVERSITY   (Taiwan)

Author keywords

Carbon monoxide; Inhalation anaesthetics, desflurane; Ventilation, fresh gas flow

Indexed keywords

ABSORBENT; CARBON DIOXIDE; CARBON MONOXIDE; DESFLURANE;

ANESTHESIA; ARTICLE; BREATHING APPARATUS; GAS FLOW; HYDRATION; OXYGEN CONSUMPTION; SIMULATION; TEMPERATURE; TUBE;

ABSORPTION; ANESTHESIA, CLOSED-CIRCUIT; ANESTHETICS, INHALATION; CARBON DIOXIDE; CARBON MONOXIDE; HUMIDITY; ISOFLURANE; OXYGEN; PARTIAL PRESSURE; REGRESSION ANALYSIS; TEMPERATURE;

EID: 46249105535     PISSN: 02650215     EISSN: 13652346     Source Type: Journal    
DOI: 10.1017/S0265021508003918     Document Type: Article

References (20)

1. Fang ZX, Eger EI II, Laster MJ, Chortkoff BS, Kandel L, Ionescu P. Carbon monoxide production from degradation of desflurane, enflurane, isoflurane, halothane, and sevoflurane by soda lime and baralyme. Anesth Analg 1995; 80: 1187-1193.
2. Baxter PJ, Garton K, Kharasch ED. Mechanistic aspects of carbon monoxide formation from volatile anaesthetics. Anesthesiology 1998; 89: 929-941.
3. Baxter PJ, Kharasch ED. Rehydration of desiccated baralyme prevents CO formation from desflurane in an anaesthesia machine. Anesthesiology 1997; 86: 1061-1065.
4. Knolle E, Heinze G, Gilly H. CO formation in dry soda lime is prolonged at low gas flow. Anesth Analg 2001; 93: 488-493.
5. Knolle E, Heinze G, Gilly H. Small CO formation in absorbents does not correlate with small CO absorption. Anesth Analg 2002; 95: 650-655.
6. Stabernack CR, Brown R, Laster MJ, Dudziak R, Eger EI II. Absorbents differ enormously in their capacity to produce compound A and CO. Anesth Analg 2000; 90: 1428-1435.
7. Tang CS, Fan SZ, Chan CC. Smoking status and body size increase carbon monoxide concentrations in the breathing circuit during low-flow anaesthesia. Anesth Analg 2001; 92: 542-547.
8. Woehlck HJ, Connolly LA, Cinquegrani MP, Dunning MB III, Hoffmann RG. Acute smoking increases ST depression in humans during general anaesthesia. Anesth Analg 1999; 89: 856-860.
9. Middleton V, Poznak AV, Artusion JF, Smith SM. Carbon monoxide accumulation in closed circle anaesthesia system. Anesthesiology 1965; 26: 715-719.
10. Woehlck HJ, Dunning MB III, Raza T, Ruiz F, Bolla B, Zink W. Physical factors affecting the production of carbon monoxide from anaesthetic breakdown. Anesthesiology 2001; 94: 453-456.
11. Knolle E, Gilly H. Absorption of carbon dioxide by dry soda lime decreases CO formation from isoflurane degradation. Anesth Analg 2000; 91: 446-451.
12. Neumann MA, Laster MJ, Weiskopf RB et al. The elimination of sodium and potassium hydroxides from desiccated soda lime diminishes degradation of desflurane to carbon monoxide and sevoflurane to compound A but does not compromise carbon monoxide absorption. Anesth Analg 1999; 89: 768-773.
13. Industrial Ventilation - A Manual of Recommended Practice, 21st edn. American Conference of Governmental Industrial Hygienists, Committee on Industrial Ventilation, Lansing, NE, USA, 1992.
14. Strum DP. Low-flow anaesthesia: anaesthetic degradation to CO and compound A. Curr Opin Anesthesiol 1995; 8: 521-525.
15. Strum DP, Eger II EI. The degradation, absorption and solubility of volatile anaesthetics in soda lime depend on water content. Anesth Analg 1994; 78: 340-348.
16. Holak EJ, Mei DA, Dunning MB III et al. Carbon monoxide production from sevoflurane breakdown: modeling of exposure under clinical conditions. Anesth Analg 2003; 96: 757-764.
17. Murray JM, Renfrew CW, Bedi A, Mccrystal CB, Jones DS, Howard Fee JP. A new CO absorbent for use in anaesthetic breathing systems. Anesthesiology 1999; 91: 1342-1348.
18. Evan DK, Powers KM, Artru AA. Comparison of Amsorb, sodalime and baralyme degradation of volatile anaesthetics and formation of CO and compound A in swine in vivo. Anesthesiology 2002; 96: 173-178.
19. Woehlck HJ. Severe intraoperative CO poisoning (Editorial Views). Anesthesiology 1999; 90: 353-354.
20. Woehlck HJ, Mei D, Dunning MB III, Ruiz F. Mathematical modeling of CO exposures from anesthetic breakdown. Anesthesiology 2001; 94: 457-460.