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Journal of Clinical Monitoring and Computing

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01-08-2018 | Review Paper

Efficient application of volatile anaesthetics: total rebreathing or specific reflection?

Authors: Hagen Bomberg, Thomas Volk, Heinrich V. Groesdonk, Andreas Meiser

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

Abstract

The circle system has been in use for more than a 100 years, whereas the first clinical application of an anaesthetic reflector was reported just 15 years ago. Its functional basis relies on molecular sieves such as zeolite crystals or activated carbon. In a circle system, the breathing gas is rebreathed after carbon dioxide absorption; a reflector on the other hand specifically retains the anaesthetic during expiration and resupplies it during the next inspiration. Reflection systems can be used in conjunction with intensive care ventilators and do not need the permanent presence of trained qualified staff. Because of easy handling and better ventilatory capabilities of intensive care ventilators, reflection systems facilitate the routine use of volatile anaesthetics in intensive care units. Until now, there are three reflection systems commercially available: the established AnaConDa™ (Sedana Medical, Uppsala, Sweden), the new smaller AnaConDa-S™, and the Mirus™ (Pall Medical, Dreieich, Germany). The AnaConDa consists only of a reflector which is connected to a syringe pump for infusion of liquid sevoflurane or isoflurane. The Mirus represents a technical advancement; its control unit includes a gas and ventilation monitor as well as a gas dispensing unit. The functionality, specific features, advantages and disadvantages of both systems are discussed in the text.

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Title: Efficient application of volatile anaesthetics: total rebreathing or specific reflection?
Authors: Hagen Bomberg
Thomas Volk
Heinrich V. Groesdonk
Andreas Meiser
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/s10877-017-0096-x

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Efficient application of volatile anaesthetics: total rebreathing or specific reflection?

Abstract

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