Agent consumption with the Zeus® in the automated closed circuit anesthesia mode with O2/air mixtures

BMC Research Notes

Andre M De Wolf¹  Jean-Luc Demeere⁴  Philip John Peyton³  Jan FA Hendrickx²  Sofie De Cooman⁴ 

[1] Department of Anesthesiology, Northwestern University Medical School, Chicago, Illinois, USA;Department of Anesthesiology/CCM, OLV Hospital, Aalst, Belgium;Department of Anesthesiology, Austin Hospital & University of Melbourne, Melbourne, Australia;Department of Anesthesiology, Kliniek Sint-Jan, Brussels, Belgium

关键词: Closed circuit anesthesia;    Equipment;    Inhaled anesthetics;   

Others  :  1131830
DOI  :  10.1186/1756-0500-7-469

 received in 2014-01-04, accepted in 2014-07-15,  发布年份 2014

【 摘 要 】

Background

Earlier software versions of the Zeus® (Lübeck, Dräger, Germany) failed to provide true closed circuit anesthesia (CCA) conditions. We examined whether the latest software (SW 4.03 MK 04672–00) achieves this goal.

Methods

In 8 ASA I–III patients, the CCA mode of the Zeus® was used to maintain the inspired O₂ (F_IO₂) and end-expired sevoflurane % (F_Asevo) at 50 and 1.8%, respectively. The fresh gas flow (FGF) of O₂ and air and the sevoflurane injection rate (=Vinj_sevo, mL liquid sevo/h) were videotaped from the control screen and entered offline into a spreadsheet. Cumulative sevoflurane usage during early wash-in (=0-1 min, CD_sevo0-1), late wash-in (=1-5 min, CD_sevo1-5), and maintenance (=5-60 min, CD_sevo5-60) was calculated, and Vinj_sevo between 1 and 60 min was compared with published uptake data.

Results

F_Asevo reached 1.8% within 101 (23) sec. CD_sevo0-1 was between 1.24 (0.03) and 3.01(0.25) mL (a range is provided because no absolute Vinj_sevo values were displayed once Vinj_sevo was > 100 mL/h, which occurred between 15 ± 2 and 46 ± 6 sec). CD_sevo1-5 was 0.81 (0.37) mL, and CD_sevo5-60 was 4.63 (0.94) mL. The Vinj_sevo pattern between 1 and 60 min matched previously published uptake data. Brief high FGF periods were used to maintain the target F_IO₂, and to refill the reservoir bag after external pressure had been applied to the abdomen; subsequent “spikes” wasted 0.08-0.19 mL and 0.14-0.49 mL sevoflurane (1-3% and 3-9% of total agent usage between 1 and 60 min, respectively).

Conclusion

Under the conditions specified, the Zeus® approaches CCA conditions so closely that further reductions in agent usage would have minimal economic significance.

【 授权许可】

   
2014 De Cooman et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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