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Evaluating the efficiency of desflurane reflection in two commercially available reflectors
Hagen Bomberg1, Marcel Wessendorf2, Martin Bellgardt3
1Department of Anesthesiology, Intensive Care Medicine and Pain Medicine Saarland University Medical Center, University of Saarland, Kirrbergerstrasse 1, 66421, Homburg/Saar, Germany. hagen.bomberg@uniklinikum-saarland.de.
Journal of Clinical Monitoring and Computing
|July 10, 2016
Summary
The AnaConDa™ and MIRUS™ systems efficiently reflect desflurane anesthetic agents in intensive care units, with AnaConDa™ showing higher efficiency. Both systems demonstrate high reflection rates suitable for clinical use, optimizing anesthetic conservation.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Respiratory Therapy
Background:
- Volatile anesthetics are used for inhalation sedation in intensive care units (ICUs).
- Anesthetic reflectors, like AnaConDa™ and MIRUS™ systems, offer an alternative to circle systems for potential agent savings.
- The efficiency of desflurane reflection by these devices is crucial for their clinical utility and cost-effectiveness.
Purpose of the Study:
- To evaluate and compare the desflurane reflection efficiency of the AnaConDa™ and MIRUS™ systems.
- To investigate the influence of varying tidal volumes (VT), respiratory rates (RR), and patient anesthetic concentrations (CPat) on reflection efficiency.
- To validate two distinct methods for measuring anesthetic reflection efficiency.
Main Methods:
- A bench study utilizing a test lung ventilated at four different settings (10x300 mL, 10x500 mL, 20x500 mL, 10x1000 mL).
- Two efficiency determination methods: a steady-state method with constant inflow/outflow and a washout method measuring decay.
- Desflurane input concentration (Cin) was varied from 1-17 vol%, and patient concentration (CPat) was monitored.
Main Results:
- Both measurement methods showed similar results (bias: -0.9%, accuracy: ±5.55%).
- Reflection efficiencies exceeding 80% were observed within the clinical range of CPat and VT.
- Efficiency demonstrated an inverse correlation with the product of CPat and VT, but not with RR. AnaConDa™ consistently outperformed MIRUS™ in efficiency across all settings.
Conclusions:
- The AnaConDa™ and MIRUS™ systems effectively reflect desflurane, achieving efficiencies suitable for clinical application in ICUs.
- The AnaConDa™ system exhibits superior desflurane reflection efficiency compared to the MIRUS™ system.
- Anesthetic agent savings are achievable with these reflector systems, particularly AnaConDa™, under typical clinical ventilation parameters.
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