Lampotang Samsun, Sanchez Justin C, Chen Baixi, Gravenstein Nikolaus
Department of Anesthesiology, University of Florida, Gainesville, FL, USA.
Anesth Analg. 2005 Jul;101(1):151-4, table of contents. doi: 10.1097/00000539-200507000-00028.
We investigated the effect of a small bellows leak (bellows full at end-expiration) on inspired oxygen fraction (Fio(2)), exhaled tidal volume (Vt), airway pressure, and room contamination in an oxygen-driven anesthesia ventilator (Ohmeda 7810, Madison, WI). CO(2) concentration at the ventilator exhalation valve, Fio(2), Vt, and airway pressure were measured (n = 3) while ventilating a CO(2)-producing test lung at 8 breaths/min and an inspiratory/expiratory ratio of 1:2, with and without a bellows leak (4-mm-long tear). Set Vt was 400, 600, 800, and 1000 mL. Fresh gas flow (FGF) was 0.3 L/min O(2) and (a) 5.0 L/min air, (b) 2.0 L/min air, and (c) 0.2 L/min nitrogen. There was no clinical difference in Fio(2), Vt, PIP (peak inspiratory pressure) and PEEP (positive end-expiratory pressure), with and without a 4-mm bellows tear, at all FGFs and Vt settings. CO(2) at the ventilator exhalation valve was always nonzero with a bellows leak, indicating that CO(2)-laden circuit gas was contaminating the drive gas via the bellows leak. A 4-mm bellows tear in an Ohmeda 7810 ventilator allows anesthetic gases to contaminate ambient air but does not cause clinically significant changes in Fio(2), exhaled Vt, PIP, or PEEP.
我们研究了小型波纹管泄漏(呼气末波纹管充满气体)对氧气驱动麻醉呼吸机(Ohmeda 7810,麦迪逊,威斯康星州)的吸入氧分数(Fio₂)、呼出潮气量(Vt)、气道压力和室内污染的影响。在以8次/分钟的呼吸频率和1:2的吸呼比为产生二氧化碳的测试肺通气时,测量了呼吸机呼气阀处的二氧化碳浓度、Fio₂、Vt和气道压力(n = 3),有无波纹管泄漏(4毫米长的撕裂口)两种情况均进行了测量。设定的Vt分别为400、600、800和1000毫升。新鲜气体流量(FGF)为0.3升/分钟氧气以及(a)5.0升/分钟空气、(b)2.0升/分钟空气和(c)0.2升/分钟氮气。在所有FGF和Vt设置下,有无4毫米波纹管撕裂时,Fio₂、Vt、吸气峰压(PIP)和呼气末正压(PEEP)在临床上均无差异。有波纹管泄漏时,呼吸机呼气阀处的二氧化碳始终不为零,这表明含二氧化碳的回路气体通过波纹管泄漏污染了驱动气体。Ohmeda 7810呼吸机上4毫米的波纹管撕裂会使麻醉气体污染周围空气,但不会导致Fio₂、呼出Vt、PIP或PEEP出现临床上的显著变化。