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Time course of inhaled anaesthetic drug delivery using a new multifunctional closed-circuit anaesthesia ventilator: in vitro comparison with a classical anaesthesia machine

Michel Struys UGent, Alain Kalmar, Luc De Baerdemaeker UGent, Eric Mortier UGent, Georges Rolly, J Manigel and W Buschke (2005) BRITISH JOURNAL OF ANAESTHESIA. 94(3). p.306-317
abstract
Background. The aim of this study was to detail the time-course, defined as the changes in end-tidal drug concentration with time, and consumption of inhaled anaesthetics when using a multifunctional closed-circuit anaesthesia machine in various drug delivery modes, and to compare it with a classical anaesthesia machine using an out-of-circle vaporizer under high and low fresh gas flow conditions. Methods. Using an artificial test lung, sevoflurane and desflurane time-course and consumption were compared when using the Zeus(R) apparatus (Drager, Lubeck, Germany) with direct injection of inhaled anaesthetics or the Primus(R) apparatus (Drager, Lubeck, Germany) using a classical out-of-circle vaporizer. Anaesthetics were targeted at 1 and 2 MAC end-tidal during 15 min. For both apparatus, out-of-circle high and low fresh gas control (FGC) and for Zeus(R), auto-control (AC) modes (fixed fresh gas flow at 6 and 1 litre min(-1) and uptake mode) were compared. Time to reach target, initial overshoot and stability at target, and wash-out times were compared. Results. In FGC, an initial overshoot in end-tidal drug concentration is seen when using 6 litre min(-1) fresh gas flow and a slower time course is observed when using only 1 litre min(-1) in both apparatus. In auto-control mode, the time course of both sevoflurane and desflurane was very fast and not influenced by the changes in fresh gas flow. No overshoot at target was seen. At all settings, the wash-out times were faster when using Zeus(R) than Primus(R). Inhaled anaesthetic consumption was lowest with the Zeus(R) ventilator in uptake AC mode. Conclusion. A combination of the fastest time course and lowest consumption of sevoflurane and desflurane was found when using the Zeus(R) apparatus in AC uptake mode.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
volatile, anaesthetics, equipment, ventilators, ventilation, fresh gas flow, SEVOFLURANE, SYSTEM, ISOFLURANE, DESFLURANE, COMPOUND, ACCUMULATION, FLOW, GAS
journal title
BRITISH JOURNAL OF ANAESTHESIA
Br. J. Anaesth.
volume
94
issue
3
pages
306 - 317
Web of Science type
Article
Web of Science id
000227127500009
JCR category
ANESTHESIOLOGY
JCR impact factor
2.425 (2005)
JCR rank
8/22 (2005)
JCR quartile
2 (2005)
ISSN
0007-0912
DOI
10.1093/bja/aei051
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
300462
handle
http://hdl.handle.net/1854/LU-300462
date created
2005-03-23 10:39:00
date last changed
2016-12-19 15:45:17
@article{300462,
  abstract     = {Background. The aim of this study was to detail the time-course, defined as the changes in end-tidal drug concentration with time, and consumption of inhaled anaesthetics when using a multifunctional closed-circuit anaesthesia machine in various drug delivery modes, and to compare it with a classical anaesthesia machine using an out-of-circle vaporizer under high and low fresh gas flow conditions. 
Methods. Using an artificial test lung, sevoflurane and desflurane time-course and consumption were compared when using the Zeus(R) apparatus (Drager, Lubeck, Germany) with direct injection of inhaled anaesthetics or the Primus(R) apparatus (Drager, Lubeck, Germany) using a classical out-of-circle vaporizer. Anaesthetics were targeted at 1 and 2 MAC end-tidal during 15 min. For both apparatus, out-of-circle high and low fresh gas control (FGC) and for Zeus(R), auto-control (AC) modes (fixed fresh gas flow at 6 and 1 litre min(-1) and uptake mode) were compared. Time to reach target, initial overshoot and stability at target, and wash-out times were compared. 
Results. In FGC, an initial overshoot in end-tidal drug concentration is seen when using 6 litre min(-1) fresh gas flow and a slower time course is observed when using only 1 litre min(-1) in both apparatus. In auto-control mode, the time course of both sevoflurane and desflurane was very fast and not influenced by the changes in fresh gas flow. No overshoot at target was seen. At all settings, the wash-out times were faster when using Zeus(R) than Primus(R). Inhaled anaesthetic consumption was lowest with the Zeus(R) ventilator in uptake AC mode. 
Conclusion. A combination of the fastest time course and lowest consumption of sevoflurane and desflurane was found when using the Zeus(R) apparatus in AC uptake mode.},
  author       = {Struys, Michel and Kalmar, Alain and De Baerdemaeker, Luc and Mortier, Eric and Rolly, Georges and Manigel, J and Buschke, W},
  issn         = {0007-0912},
  journal      = {BRITISH JOURNAL OF ANAESTHESIA},
  keyword      = {volatile,anaesthetics,equipment,ventilators,ventilation,fresh gas flow,SEVOFLURANE,SYSTEM,ISOFLURANE,DESFLURANE,COMPOUND,ACCUMULATION,FLOW,GAS},
  language     = {eng},
  number       = {3},
  pages        = {306--317},
  title        = {Time course of inhaled anaesthetic drug delivery using a new multifunctional closed-circuit anaesthesia ventilator: in vitro comparison with a classical anaesthesia machine},
  url          = {http://dx.doi.org/10.1093/bja/aei051},
  volume       = {94},
  year         = {2005},
}

Chicago
Struys, Michel, Alain Kalmar, Luc De Baerdemaeker, Eric Mortier, Georges Rolly, J Manigel, and W Buschke. 2005. “Time Course of Inhaled Anaesthetic Drug Delivery Using a New Multifunctional Closed-circuit Anaesthesia Ventilator: In Vitro Comparison with a Classical Anaesthesia Machine.” British Journal of Anaesthesia 94 (3): 306–317.
APA
Struys, M., Kalmar, A., De Baerdemaeker, L., Mortier, E., Rolly, G., Manigel, J., & Buschke, W. (2005). Time course of inhaled anaesthetic drug delivery using a new multifunctional closed-circuit anaesthesia ventilator: in vitro comparison with a classical anaesthesia machine. BRITISH JOURNAL OF ANAESTHESIA, 94(3), 306–317.
Vancouver
1.
Struys M, Kalmar A, De Baerdemaeker L, Mortier E, Rolly G, Manigel J, et al. Time course of inhaled anaesthetic drug delivery using a new multifunctional closed-circuit anaesthesia ventilator: in vitro comparison with a classical anaesthesia machine. BRITISH JOURNAL OF ANAESTHESIA. 2005;94(3):306–17.
MLA
Struys, Michel, Alain Kalmar, Luc De Baerdemaeker, et al. “Time Course of Inhaled Anaesthetic Drug Delivery Using a New Multifunctional Closed-circuit Anaesthesia Ventilator: In Vitro Comparison with a Classical Anaesthesia Machine.” BRITISH JOURNAL OF ANAESTHESIA 94.3 (2005): 306–317. Print.