학술논문
Comparison of the use of AnaConDa® versus AnaConDa-S® during the post-operative period of cardiac surgery under standard conditions of practice.
Document Type
Academic Journal
Author
Marcos-Vidal JM; Anaesthesiology and Critical Care, Hospital de León, University Hospital Complex, C/Altos de Nava s/n, 24071, Leon, Spain. jmmarcosv@hotmail.com.; Merino M; Anaesthesiology and Critical Care, Hospital de León, University Hospital Complex, C/Altos de Nava s/n, 24071, Leon, Spain.; González R; Anaesthesiology and Critical Care, Hospital de León, University Hospital Complex, C/Altos de Nava s/n, 24071, Leon, Spain.; García C; Anaesthesiology and Critical Care, Hospital de León, University Hospital Complex, C/Altos de Nava s/n, 24071, Leon, Spain.; Rey S; Anaesthesiology and Critical Care, Hospital de León, University Hospital Complex, C/Altos de Nava s/n, 24071, Leon, Spain.; Pérez I; Anaesthesiology and Critical Care, Hospital de León, University Hospital Complex, C/Altos de Nava s/n, 24071, Leon, Spain.
Source
Publisher: Springer Country of Publication: Netherlands NLM ID: 9806357 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2614 (Electronic) Linking ISSN: 13871307 NLM ISO Abbreviation: J Clin Monit Comput Subsets: MEDLINE
Subject
Language
English
Abstract
Changes have been made to the AnaConDa device (Sedana Medical, Stockholm, Sweden), decreasing its size to reduce dead space and carbon dioxide (CO 2 ) retention. However, this also involves a decrease in the surface area of the activated carbon filter. The CO 2 elimination and sevoflurane (SEV) reflection of the old device (ACD-100) were thus compared with the new version (ACD-50) in patients sedated after coronary artery bypass graft surgery. After ERC approval and written informed consent, 23 patients were sedated with SEV, using first the ACD-100 and then the ACD-50 for 60 min each. With each device, patients were ventilated with tidal volumes (TV) of 5 ml/kg of ideal body weight for the first 30 min, and with 7 ml/kg for the next 30 min. Ventilation parameters, arterial blood gases, Bispectral-Index™ (BIS, Aspect Medical Systems Inc., Newton, MA, USA), SEV concentrations exhaled by the patient (SEV-exhaled) and from the expiratory hose (SEV-lost) were recorded every 30 min. A SEV reflection index was calculated: SRI [%] = 100 × (1 - (SEV-lost/SEV-exhaled)). Data were compared using ANOVA with repeated measurements and Student's T-tests for pairs. Respiratory rates, tidal and minute volumes were not significantly different between the two devices. End tidal and arterial CO 2 partial pressures were significantly higher with the ACD-100 as compared with the ACD-50. SEV infusion rate remained constant. SEV reflection was higher (SRI: ACD-100 vs. ACD-50, TV 5 ml/kg: 95.29 ± 6.45 vs. 85.54 ± 11.15, p = 0.001; 7 ml/kg: 93.42 ± 6.55 vs. 88.77 ± 12.26, p = 0.003). BIS was significantly lower when using the higher TV (60.91 ± 9.99 vs. 66.57 ± 8.22, p = 0.012), although this difference was not clinically relevant. During postoperative sedation, the use of ACD-50 significantly reduced CO 2 retention. SEV reflection was slightly reduced. However, patients remained sufficiently sedated without increasing SEV infusion.