4種類のプレフィルドCO₂吸収剤ブランドの臨床現場における有効性の比較
Jung-Bin Park1, Sang-Hwan Ji1, Young-Eun Jang1
1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
Background:
Evidence regarding CO2 absorbent performance in real clinical settings is limited. This study compared the CO2 absorption capacity of four pre-filled CO2 absorbent brands using two different anesthesia machines in clinical practice.
Methods:
This single-center retrospective study included 3,401 surgical cases who received general anesthesia from November 2022 to January 2024. Four CO2 absorbents-AMSORB® Plus, SpiraLith®, CLIC Drägersorb® Absorber 800 + , and Drägersorb® Free-were used in GE Avance and Dräger Primus anesthesia machines. The primary outcome was CO2 absorption capacity, calculated based on the estimated CO2 consumption for each patient per canister. Secondary outcomes included total number of surgical cases, cumulative anesthesia time and capacity until inspired CO2 partial pressure (PiCO2) reached 5 mmHg, as well as transition time from 3 to 5 mmHg.
Results:
SpiraLith® showed a higher CO2 absorption capacity compared to AMSORB® Plus in GE Avance anesthesia machine (280.8 ± 116.9 L vs. 435.3 ± 101.6 L; mean difference 154.6 L; 95% CI, 72.5 to 236.6; p = 0.006). In Dräger Primus machines, CLIC Drägersorb® Absorber 800 + demonstrated the highest CO2 absorption capacity, outperforming both Drägersorb® Free and SpiraLith®, with considerable variability (582.5 ± 249.7 vs. 434.1 ± 138.4 vs.379.8 ± 70.4; p = 0.001). However, SpiraLith® showed a significantly extended usage time and capacity until PiCO2 increased from 3 to 5 mmHg when compared to the other two products.
Conclusions:
In vivo performance of prefilled CO₂ absorbents may differ from previously reported in vitro results and can vary according to particle composition and device-specific conditions.
