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Only carbon dioxide absorbents free of both NaOH and KOH do not generate compound A during in vitro closed-system sevoflurane: evaluation of five absorbents

Linda Versichelen UGent, Marie-Paule Bouche, Georges Rolly UGent, Jan Van Bocxlaer UGent, Michel Struys UGent, Andreas De Leenheer UGent and Eric Mortier UGent (2001) ANESTHESIOLOGY. 95(3). p.750-755
abstract
Background insufficient data exist on the production of compound A during closed-system sevoflurane administration with newer carbon dioxide absorbents. Methods: A modified PhysioFlex apparatus (Drager, Lubeck, Germany) was connected to an artificial test lung (Inflow at the top of the bellow congruent to 160 ml/min CO2; outflow at the Y piece of the lung model congruent to 200 ml/min, simulating oxygen consumption). Ventilation was set to obtain an end-tidal carbon dioxide partial pressure of approximately 40 mmHg. Various fresh carbon dioxide absorbents were used: Sodasorb (n = 6), Sofnolime (n = 6), and potassium hydroxide (KOH)-free Sodasorb (n = 7), Amsorb (n = 7), and lithium hydroxide (n = 7). After baseline analysis, liquid sevoflurane was Injected into the circuit by syringe pump to obtain 2.1% end-tidal concentration for 240 min. At baseline and at regular intervals thereafter, end-tidal carbon dioxide partial pressure, end-tidal sevoflurane concentration, and canister inflow (T degrees (in)) and canister outflow (T degrees (out)) temperatures were measured. To measure compound A(insp) concentration in the inspired gas of the breathing circuit, 2-ml gas samples were taken and analyzed by capillary gas chromatography plus mass spectrometry. Results: The median (minimum-maximum) highest compound A(insp) concentrations over the entire period were, in decreasing order: 38.3 (28.4-44.2)* (Sofnolime), 30.1 (23.9-43.7) (KOH-free Sodasorb), 23.3 (20.0-29.2) (Sodasorb), 1.6 (1.3-2.1)* (lithium hydroxide), and 1.3 (1.1-1.8)* (Arnsorb) parts per million (*P < 0.01 vs. Sodasorb). After reaching their peak concentration, a decrease for Sofnolime, KOH-free Sodasorb, and Sodasorb until 240 min was found. The median (minimum-maximum) highest values for T degrees (out), were 39 (38-40), 40 (39-42), 41 (40-42), 46 (44-48)*, and 39 (38-41) IC (*P < 0.01 vs. Sodasorb), respectively. Conclusions: With KOH-free (but sodium hydroxide [NaOH]containing) soda limes even higher compound A concentrations are recorded than with standard Sodasorb. Only by eliminating KOH as well as NaoH from the absorbent (Amsorb and lithium hydroxide) is no compound A produced.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (proceedingsPaper)
publication status
published
subject
keyword
BREATHING SYSTEMS, SODA LIME, DEGRADATION, MONOXIDE, ABSORPTION, PRODUCE
journal title
ANESTHESIOLOGY
Anesthesiology
volume
95
issue
3
pages
750 - 755
conference name
Annual Meeting American Society of Anesthesiologists
conference location
San Francisco, CA, USA
conference start
2000-10-14
conference end
2000-10-18
Web of Science type
Article
Web of Science id
000170872900026
JCR category
ANESTHESIOLOGY
JCR impact factor
3.381 (2001)
JCR rank
2/22 (2001)
JCR quartile
1 (2001)
ISSN
0003-3022
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
143130
handle
http://hdl.handle.net/1854/LU-143130
date created
2004-01-14 13:37:00
date last changed
2011-05-02 13:22:46
@article{143130,
  abstract     = {Background insufficient data exist on the production of compound A during closed-system sevoflurane administration with newer carbon dioxide absorbents.
Methods: A modified PhysioFlex apparatus (Drager, Lubeck, Germany) was connected to an artificial test lung (Inflow at the top of the bellow congruent to 160 ml/min CO2; outflow at the Y piece of the lung model congruent to 200 ml/min, simulating oxygen consumption). Ventilation was set to obtain an end-tidal carbon dioxide partial pressure of approximately 40 mmHg. Various fresh carbon dioxide absorbents were used: Sodasorb (n = 6), Sofnolime (n = 6), and potassium hydroxide (KOH)-free Sodasorb (n = 7), Amsorb (n = 7), and lithium hydroxide (n = 7). After baseline analysis, liquid sevoflurane was Injected into the circuit by syringe pump to obtain 2.1\% end-tidal concentration for 240 min. At baseline and at regular intervals thereafter, end-tidal carbon dioxide partial pressure, end-tidal sevoflurane concentration, and canister inflow (T degrees (in)) and canister outflow (T degrees (out)) temperatures were measured. To measure compound A(insp) concentration in the inspired gas of the breathing circuit, 2-ml gas samples were taken and analyzed by capillary gas chromatography plus mass spectrometry.
Results: The median (minimum-maximum) highest compound A(insp) concentrations over the entire period were, in decreasing order: 38.3 (28.4-44.2)* (Sofnolime), 30.1 (23.9-43.7) (KOH-free Sodasorb), 23.3 (20.0-29.2) (Sodasorb), 1.6 (1.3-2.1)* (lithium hydroxide), and 1.3 (1.1-1.8)* (Arnsorb) parts per million (*P {\textlangle} 0.01 vs. Sodasorb). After reaching their peak concentration, a decrease for Sofnolime, KOH-free Sodasorb, and Sodasorb until 240 min was found. The median (minimum-maximum) highest values for T degrees (out), were 39 (38-40), 40 (39-42), 41 (40-42), 46 (44-48)*, and 39 (38-41) IC (*P {\textlangle} 0.01 vs. Sodasorb), respectively.
Conclusions: With KOH-free (but sodium hydroxide [NaOH]containing) soda limes even higher compound A concentrations are recorded than with standard Sodasorb. Only by eliminating KOH as well as NaoH from the absorbent (Amsorb and lithium hydroxide) is no compound A produced.},
  author       = {Versichelen, Linda and Bouche, Marie-Paule and Rolly, Georges and Van Bocxlaer, Jan and Struys, Michel and De Leenheer, Andreas and Mortier, Eric},
  issn         = {0003-3022},
  journal      = {ANESTHESIOLOGY},
  keyword      = {BREATHING SYSTEMS,SODA LIME,DEGRADATION,MONOXIDE,ABSORPTION,PRODUCE},
  language     = {eng},
  location     = {San Francisco, CA, USA},
  number       = {3},
  pages        = {750--755},
  title        = {Only carbon dioxide absorbents free of both NaOH and KOH do not generate compound A during in vitro closed-system sevoflurane: evaluation of five absorbents},
  volume       = {95},
  year         = {2001},
}

Chicago
Versichelen, Linda, Marie-Paule Bouche, Georges Rolly, Jan Van Bocxlaer, Michel Struys, Andreas De Leenheer, and Eric Mortier. 2001. “Only Carbon Dioxide Absorbents Free of Both NaOH and KOH Do Not Generate Compound A During in Vitro Closed-system Sevoflurane: Evaluation of Five Absorbents.” Anesthesiology 95 (3): 750–755.
APA
Versichelen, L., Bouche, M.-P., Rolly, G., Van Bocxlaer, J., Struys, M., De Leenheer, A., & Mortier, E. (2001). Only carbon dioxide absorbents free of both NaOH and KOH do not generate compound A during in vitro closed-system sevoflurane: evaluation of five absorbents. ANESTHESIOLOGY, 95(3), 750–755. Presented at the Annual Meeting American Society of Anesthesiologists.
Vancouver
1.
Versichelen L, Bouche M-P, Rolly G, Van Bocxlaer J, Struys M, De Leenheer A, et al. Only carbon dioxide absorbents free of both NaOH and KOH do not generate compound A during in vitro closed-system sevoflurane: evaluation of five absorbents. ANESTHESIOLOGY. 2001;95(3):750–5.
MLA
Versichelen, Linda, Marie-Paule Bouche, Georges Rolly, et al. “Only Carbon Dioxide Absorbents Free of Both NaOH and KOH Do Not Generate Compound A During in Vitro Closed-system Sevoflurane: Evaluation of Five Absorbents.” ANESTHESIOLOGY 95.3 (2001): 750–755. Print.