Please use this identifier to cite or link to this item: doi:10.22028/D291-40688
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Title: Evaluating the efficiency of desflurane reflection in two commercially available reflectors
Author(s): Bomberg, Hagen
Wessendorf, Marcel
Bellgardt, Martin
Veddeler, Max
Wagenpfeil, Stefan
Volk, Thomas
Groesdonk, Heinrich V
Meiser, Andreas
Language: English
Title: Journal of clinical monitoring and computing
Volume: 32
Issue: 4
Pages: 605–614
Publisher/Platform: Springer
Year of Publication: 2018
Free key words: Efficiency reflection
Sedation
Intensive care unit (ICU)
MIRUS™
AnaConDa™
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: With the AnaConDa™ and the MIRUS™ system, volatile anesthetics can be administered for inhalation sedation in intensive care units. Instead of a circle system, both devices use anesthetic reflectors to save on the anesthetic agent. We studied the efficiency of desflurane reflection with both devices using different tidal volumes (VT), respiratory rates (RR), and 'patient' concentrations (CPat) in a bench study. A test lung was ventilated with four settings (volume control, RR × VT: 10 × 300 mL, 10 × 500 mL, 20 × 500 mL, 10 × 1000 mL). Two different methods for determination of reflection efficiency were established: First (steady state), a bypass flow carried desflurane into the test lung (flowin), the input concentration (Cin) was varied (1-17 vol%), and the same flow (flowex, Cex) was suctioned from the test lung. After equilibration, CPat was stored online and averaged; efficiency [%] was calculated [Formula: see text]. Second (washout), flowin and flowex were stopped, the decline of CPat was measured; efficiency was calculated from the decay constant of the exponential regression equation. Both measurement methods yielded similar results (Bland-Altman: bias: -0.9 %, accuracy: ±5.55 %). Efficiencies higher than 80 % (>80 % of molecules exhaled are reflected) could be demonstrated in the clinical range of CPat and VT. Efficiency inversely correlates with the product of CPat and VT which can be imagined as the volume of anesthetic vapor exhaled by the patient in one breath, but not with the respiratory frequency. Efficiency of the AnaConDa™ was higher for each setting compared with the MIRUS™. Desflurane is reflected by both reflectors with efficiencies high enough for clinical use.
DOI of the first publication: 10.1007/s10877-016-9902-0
URL of the first publication: https://link.springer.com/article/10.1007/s10877-016-9902-0
Link to this record: urn:nbn:de:bsz:291--ds-406882
hdl:20.500.11880/36574
http://dx.doi.org/10.22028/D291-40688
ISSN: 1387-1307
1573-2614
Date of registration: 9-Oct-2023
Faculty: M - Medizinische Fakultät
Department: M - Anästhesiologie
M - Medizinische Biometrie, Epidemiologie und medizinische Informatik
Professorship: M - Prof. Dr. Thomas Volk
M - Prof. Dr. Stefan Wagenpfeil
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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