Air-oxygen mixtures in circle systems
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Published on: August 3, 2021
J F Hendrickx1, S De Cooman, D M Vandeput
1Department of Anesthesiology, Intensive Care and Pain Therapy, Onze Lieve Vrouwziekenhuis, Aalst, Belgium.
Study Objective:
To determine the effect of different air-O(2) mixtures and fresh gas flows (FGF) on the relationship between the delivered (F(Del)O(2)) and inspired O(2) fraction (FIO(2)) in a circle system.
Study Design:
Randomized clinical study.
Setting:
Large teaching hospital.
Patients:
160 ASA physical status I, II, and III patients undergoing a variety of cardiovascular procedures with general endotracheal anesthesia.
Interventions:
160 patients were randomly assigned to one of 20 groups (n = 8 each), depending on the combination of total FGF (0.5, 1, 2, 4, or 8 L/min) and air-O(2) mixture used (ratios of 4/1, 3/2, 2/3, or 1/4), corresponding to a F(Del)O(2) of 0.37, 0.53, 0.68, and 0.84. For each combination of FGF and air-O(2) mixture, FIO(2) after equilibration was compared with F(Del)O(2).
Measurements And Main Results:
With any air-O(2) mixture with a FGF < or = 2 L/min, FIO(2) became lower than F(Del)O(2). Because FIO(2) decreased below 0.25 after 13 and 26 minutes in the first two patients of the 4/1 0.5 L/min air-O(2) group, this study limb was terminated.
Conclusions:
When using air-O(2) mixtures in a circle system, FIO(2) becomes lower than the F(Del)O(2) with FGF < or = 2 L/min. The relative proportion of O(2) in the FGF has to be increased accordingly.
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