Der Anaesthesist
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Randomized Controlled Trial Clinical Trial
[The effect of a heat and moisture exchanger (HME) on bronchial mucus transport in a closed inhalation anesthesia system].
The administration of dry anaesthetic gases for ventilation leads to morphological changes of the tracheobronchial epithelium that may cause postoperative pulmonary complications. Therefore, additional humidification with a heat and moisture exchanger (HME) is suggested for ventilation during anaesthesia, particularly when using semi-open breathing systems. Recommendations concerning the use of a HME in the semi-closed system are controversial. There are no data in the literature as to whether a HME improves mucociliary transport under these conditions. We therefore studied bronchial mucus transport velocity (BTV) with and without the use of a HME in the semi-closed circle system in humans. ⋯ BTV does not improve with the use of a HME in the semi-closed circle system with a fresh gas flow of 31. With modern anaesthesia machines lower fresh gas flows should be administered, whereby the humidity and temperature of the inspired gases are further increased.
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Randomized Controlled Trial Clinical Trial
[The interaction of nitrous oxide and enflurane on the EEG median of 2-3 Hz is additive, but weaker than at 1.0 MAC].
The aim of this study was to quantify the interaction of enflurane and nitrous oxide at a constant median EEG frequency. ⋯ The interaction of enflurane and nitrous oxide in the dose range from 0 to 75 vol.-% on median EEG frequency is compatible with additivity. The potency of nitrous oxide as a substitute for enflurane is less than might be expected when adding up the MAC values.
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Comparative Study
[Comparative study of the efficiency of bacterial filters in long-term mechanical ventilation].
Two commercially available bacterial filters to be used as part of the mechanical ventilation unit during anaesthesia were tested for hygienic criteria. Manufacturers claim that bacterial breathing filters have a filtration capacity of about 99.995%, so that there would be no need for thermal disinfection of tubing and ventilation circuits after each use. One filter is designed for a single use only, the other can be used up to 24 times after sterilisation. Both filters consist of hydrophobic glass fibres. ⋯ The use of bacterial filters during mechanical ventilation reduces the probability of bacterial contamination, but does not make sterilisation of the tubes and ventilation circuit unnecessary.
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In the presence of completely dry soda lime volatile anaesthetics will decompose to carbon monoxide (CO). In an in vitro study, the absorbent (soda lime, ICI) was dried with a constant gas flow of 11/min oxygen for 120 h. The weight loss during the drying was 17.1%. ⋯ The temperature inside the absorbent rose from the ambient temperature (19.8 degrees C) to a maximum of 52.1 degrees C during CO production and decreased when the CO production lowered after approximately 1 h (all anaesthetics). During CO production no measurable concentration of halothane left the absorber. After passing through the absorbent the concentrations of isoflurane and enflurane were slightly lower than the corresponding concentrations in the fresh gas measured before absorption.