Baum J, Enzenauer J, Krausse T, Sachs G
Abteilung für Anästhesie und Intensivmedizin, Krankenhaus St. Elisabeth-Stift, Damme.
Anaesthesiol Reanim. 1993;18(4):108-13.
The utilisation time of carbon dioxide absorbers in anaesthesia textbooks is nearly identically specified to last about 5 hours. Therefore in most departments the soda lime of the absorbers is changed routinely on a daily schedule. As rebreathing volume increases considerably with fresh gas flow reduction, the question arises as to whether the soda lime should be changed at even shorter intervals--if low-flow anaesthesia is performed routinely--to to guarantee carbon dioxide absorption safely. In three anaesthesia machines with different technical properties the carbon dioxide absorbers were only changed when the inspiratory carbon dioxide concentration increased to 1 vol. %, indicating definite exhaustion of the soda lime. If a fresh gas flow of 4.4 l/min was used exclusively, utilisation times of 42.7 and 62.3 hours were measured using absorbers filled with 1 l of soda lime pellets, whereas a utilisation time of 98.7 hours was noted with a 1.5 l absorber, all values being surprisingly higher than the above-mentioned figure. If, however, minimal flow anaesthesia is performed routinely in clinical practice, the percentage of time in which the fresh gas flow can really be reduced to 0.5 l/min does not exceed 50 to 80%. Under these conditions the utilisation time of the absorbers decreases to between one half (1/2) and one quarter (1/4) of the utilisation time which can be gained if a flow of 4.4 l/min is used. Thus, the performance of minimal-flow anaesthesia increases the consumption of soda lime two- to fourfold.(ABSTRACT TRUNCATED AT 250 WORDS)
麻醉学教科书中规定二氧化碳吸收剂的使用时间几乎相同,约为5小时。因此,在大多数科室,吸收器中的苏打石灰通常按每日计划更换。随着新鲜气体流量减少,重复吸入量会大幅增加,于是出现了一个问题:如果常规进行低流量麻醉,苏打石灰是否应更短间隔更换,以确保安全吸收二氧化碳。在三台技术性能不同的麻醉机中,只有当吸气二氧化碳浓度升至1%(体积),表明苏打石灰确实耗尽时,才更换二氧化碳吸收器。若仅使用4.4升/分钟的新鲜气体流量,使用装有1升苏打石灰颗粒的吸收器时,测量到的使用时间分别为42.7小时和62.3小时,而使用1.5升吸收器时为98.7小时,所有这些值均惊人地高于上述数字。然而,在临床实践中如果常规进行微流量麻醉,新鲜气体流量真正能降至0.5升/分钟的时间百分比不超过50%至80%。在这些条件下,吸收器的使用时间降至以4.4升/分钟流量时所能达到的使用时间的二分之一(1/2)至四分之一(1/4)。因此,微流量麻醉会使苏打石灰的消耗量增加两至四倍。(摘要截短至250字)