Accuracy of calculated volatile agent consumption from fresh课件.pptVIP

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2016-03-20 发布于广东
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Accuracy of calculated volatile agent consumption from fresh课件.ppt

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Accuracy of calculated volatile agent consumption from fresh gas content Introduction Due to pharmaco-economic and environmental considerations, consumption of volatile anesthetics (VA) during inhalational anesthesia gains increasing importance. Therefore, more efforts have to be directed toward assessment of consumed liquid VA per case in order to apply agent sparing measures. The knowledge of the VA consumption per case also might be used for billing. The most precise and reliable technique to assess VA consumption is weighing the vaporizer before and after anesthesia. The obtained difference is used to calculate the consumed amount of liquid anesthetic. This has been widely performed for various investigations about VA consumption. However, this method requires a very precise balance with a wide range of measurement that is able to discern weight differences of a few grams in a vaporizer weighing up to 9 kg. Besides the fact that such high-end balances are not always and anywhere available, this technique can only be applied if the assessment is planned in advance and due to its complexity may be restricted to few cases only. Another, much easier possibility to monitor VA consumption is to extract the consumed VA amount at the end of an anesthesia from the logbook of the anesthesia respirator, if equipped with this feature. However, this capability is restricted to few and very recent anesthesia respirators. In a recent study, we could show that the reliability of the built-in VA consumption reading is acceptable. Since more than two decades, a reliable calculation method for the assessment of VA consumption is known, if two essential details are available: (1) the course of fresh gas flow (FGF) (2) the VA concentration throughout the time of VA delivery. These calculations are based on known physical properties of the involved VA, as well as the laws of evaporation under defined conditions, with known deviation from SPDT (standard temperature, st