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Journal of Clinical Monitoring and Computing

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01-08-2018 | Original Research

Technology III: in-line vaporizer with reflector

Authors: A. Mashari, J. A. Fisher, L. Fedorko, M. Wąsowicz, M. Meineri

Published in: Journal of Clinical Monitoring and Computing | Issue 4/2018

Abstract

As the clinical advantages of vapor anesthesia (VA) for sedation of patients in ICU become more apparent, the ergonomics, economy and safety issues need to be better addressed. Here we describe the use of a new commercial digital in-line anesthetic vaporizer that can be attached to the inspiratory limb of a ventilator. If used with a simple, and easily assembled secondary circuit and anesthetic reflector, the circuit remains remote from the patient, the VA consumption approaches a physical minimum, VA level is controlled and monitored, and the tidal volume size is not limited.

For example, AVEA (Carefusion, Yorba Linda, USA) performs a preparatory self-test to determine total circuit compliance. This would be performed with the RIVAL in the circuit. The iVent (GE Healthcare), performs a brief inspiratory hold to calculate static compliance. However, actual performance of specific ventilators with RIVAL would have to be tested.

Azami T, et al. Calculation of O2 consumption during low-flow anesthesia from tidal gas concentrations, flowmeter, and minute ventilation. J Clin Monit Comput. 2004;18:325–32.CrossRef

Yasny JS, White J. Environmental implications of anesthetic gases. Anesth Prog. 2012;59:154–8.CrossRef

Bomberg H, et al. A novel device for target controlled administration and reflection of desflurane—the Mirus. Anaesthesia. 2014;69:1241–50.CrossRef

Dahm SL, Steptoe P, Luttropp HH, Reinstrup P. Charcoal as an airway isoflurane reflection filter. Eur J Anaesthesiol. 1998;15:230–3.CrossRef

Tempia A, et al. The anesthetic conserving device compared with conventional circle system used under different flow conditions for inhaled anesthesia. Anesth Analg. 2003;96:1056–61 (table of contents).CrossRef

Thomasson R, Luttropp HH, Werner O. A reflection filter for isoflurane and other anaesthetic vapours. Eur J Anaesthesiol. 1989;6:89–94.PubMed

Perhag L, Reinstrup P, Thomasson R, Werner O. The Reflector: a new method for saving anaesthetic vapours. Br J Anaesth. 2000;85:482–6.CrossRef

Belda JF, et al. The predictive performance of a pharmacokinetic model for manually adjusted infusion of liquid sevofluorane for use with the Anesthetic-Conserving Device (AnaConDa): a clinical study. Anesth Analg. 2008;106:1207–14 (table of contents).CrossRef

Laferriere-Langlois P, d AF, Manzanares W. Halogenated volatile anesthetics in the intensive care unit: current knowledge on an upcoming practice. Minerva Anestesiol. 2017;83:737–48.PubMed

10.

Sturesson LW, Bodelsson M, Jonson B, Malmkvist G. Anaesthetic conserving device AnaConDa: dead space effect and significance for lung protective ventilation. Br J Anaesth. 2014;113:508–14.CrossRef

11.

Mashari A, Fedorko L, Fisher JA, Klein M, Wąsowicz M, Meineri M. High volatile anaesthetic conservation with a digital in-line vaporizer and a reflector. Actal anaesthesiol Scand. 2017. https://doi.org/10.1111/aas.13017

Title: Technology III: in-line vaporizer with reflector
Authors: A. Mashari
J. A. Fisher
L. Fedorko
M. Wąsowicz
M. Meineri
Publication date: 01-08-2018
Publisher: Springer Netherlands
Published in: Journal of Clinical Monitoring and Computing / Issue 4/2018
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-017-0078-z

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Technology III: in-line vaporizer with reflector

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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