In vitro performance of prefilled CO2 absorbers with the Aisys®

Jan F.A. Hendrickx*, Simon P.A.J. De Ridder, Alexander Dehouwer, Rik Carette, Sofie De Cooman, Andre M. De Wolf

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Low flow anesthesia increases the use of CO2 absorbents, but independent data that compare canister life of the newest CO2 absorbents are scarce. Seven different pre-packed CO2 canisters were tested in vitro: Amsorb Plus, Spherasorb, LoFloSorb, Medisorb, Medisorb EF, LithoLyme, and SpiraLith. CO2 (160 mL min−1) flowed into the tip of a 2 L breathing bag that was ventilated with a tidal volume of 500 mL, a respiratory rate of 10/min, and an I:E ratio of 1:1 using the controlled mechanical ventilation mode of the Aisys® (GE, Madison, WI, USA). In part I, canister life of each brand (all of the same lot) was tested with 12 different fresh gas flows (FGF) ranging from 0.25 to 4 L min−1. In part II, canister life of six canisters each of two different lots of each brand were tested with a 350 mL min−1 FGF. Canister life is presented as “FCU”, fractional canister usage, the fraction of a canister used per hour, and is defined for the inspired CO2 concentration (FICO2) that denotes exhaustion. In part III, canister life per 100 g fresh granule content was calculated. FCU decreased linearly with increasing FGF. The relative position of the FCU–FGF curves of the different brands depends on the FICO2 threshold because the exhaustion rate (the rate of rise once FICO2 starts to increase) differs among the brands. Intra-lot variability was 18 % or less. The different prepacks can be ranked according their efficiency (least to most efficient) as follows: Amsorb Plus = Medisorb EF < LoFloSorb < Medisorb = Spherasorb = LithoLyme < SpiraLith (all for an FICO2 threshold = 0.5 %). Canister life per 100 g fresh granule content is almost twice as long when LiOH is used as the primary absorbent. The most important factors that determine canister life of prepacks in a circle breathing system are the chemical composition of the canister, the absolute amount of absorbent present in the canister, and the FICO2 replacement threshold. The use of the fractional canister usage allows cost comparisons among different prepacks. Results should not be extrapolated to prepacks that fit onto other anesthesia machines.

Original languageEnglish (US)
Pages (from-to)193-202
Number of pages10
JournalJournal of Clinical Monitoring and Computing
Volume30
Issue number2
DOIs
StatePublished - Apr 1 2016

Keywords

  • Anesthesia machine
  • CO absorbers
  • Low flow anesthesia

ASJC Scopus subject areas

  • Health Informatics
  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

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