Veterinary anaesthesia and analgesia · 2026
Evaluation of an anaesthetic conserving device in semi-closed rebreathing systems using an artificial lung with isoflurane and sevoflurane: an in vitro pilot study.
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Flyps Jana, Haspeslagh Maarten, Bouchez Stefaan, Schauvliege Stijn
Аннотация
OBJECTIVE: To evaluate the performance of an anaesthetic conserving device (ACD), in semi-closed rebreathing systems.
STUDY DESIGN: In vitro pilot study.
ANIMALS: None.
METHODS: First, an ACD was positioned between an artificial lung and the Y-piece of a human anaesthesia machine with a ventilator, delivering tidal volumes (VTs) of 350, 500, 800, and 1200 mL. Second, using a three-dimensionally printed connector, four ACDs were placed in parallel between the artificial lung and the Y-piece of a large animal anaesthesia machine with a ventilator, delivering VTs of 4000 and 6000 mL. Each VT, delivered during volume-controlled ventilation, was tested using isoflurane and sevoflurane and using 0 and 10 cmH2O of positive end-expiratory pressure (PEEP). Anaesthetic agents were delivered via continuous infusion, aiming for end-tidal concentrations of 1.0% (isoflurane) and 2.0% (sevoflurane). Inspiratory and expiratory vapour concentrations were monitored continuously at the ACD sampling port and at the Y-piece over a 30-minute period. The anaesthetic agent breakthrough (the proportion of exhaled anaesthetic vapour not captured by the ACD) was calculated for each setting and adjusted for the effect of recirculation (recirculation-adjusted breakthrough).
RESULTS: At low VTs (≤500 mL), the ACD adsorbed efficiently, with no (isoflurane) to minimal (≤20%) (sevoflurane) loss detected. As VT increased (≥800 mL), breakthrough became greater, ranging from 20% to 28% and 40% to 53% for isoflurane and sevoflurane, respectively. The highest recirculation-adjusted breakthrough occurred at 6000 mL with 10 cmH2O PEEP for isoflurane (28%) and at 800 mL with 10 cmH2O PEEP for sevoflurane (53%). Sevoflurane showed higher breakthrough than isoflurane for all settings.
CONCLUSIONS AND CLINICAL RELEVANCE: This is the first study to evaluate an ACD in semi-closed rebreathing systems. The results show that although the ACD effectively captures volatile anaesthetics at low VTs, its breakthrough increased at higher VTs.
STUDY DESIGN: In vitro pilot study.
ANIMALS: None.
METHODS: First, an ACD was positioned between an artificial lung and the Y-piece of a human anaesthesia machine with a ventilator, delivering tidal volumes (VTs) of 350, 500, 800, and 1200 mL. Second, using a three-dimensionally printed connector, four ACDs were placed in parallel between the artificial lung and the Y-piece of a large animal anaesthesia machine with a ventilator, delivering VTs of 4000 and 6000 mL. Each VT, delivered during volume-controlled ventilation, was tested using isoflurane and sevoflurane and using 0 and 10 cmH2O of positive end-expiratory pressure (PEEP). Anaesthetic agents were delivered via continuous infusion, aiming for end-tidal concentrations of 1.0% (isoflurane) and 2.0% (sevoflurane). Inspiratory and expiratory vapour concentrations were monitored continuously at the ACD sampling port and at the Y-piece over a 30-minute period. The anaesthetic agent breakthrough (the proportion of exhaled anaesthetic vapour not captured by the ACD) was calculated for each setting and adjusted for the effect of recirculation (recirculation-adjusted breakthrough).
RESULTS: At low VTs (≤500 mL), the ACD adsorbed efficiently, with no (isoflurane) to minimal (≤20%) (sevoflurane) loss detected. As VT increased (≥800 mL), breakthrough became greater, ranging from 20% to 28% and 40% to 53% for isoflurane and sevoflurane, respectively. The highest recirculation-adjusted breakthrough occurred at 6000 mL with 10 cmH2O PEEP for isoflurane (28%) and at 800 mL with 10 cmH2O PEEP for sevoflurane (53%). Sevoflurane showed higher breakthrough than isoflurane for all settings.
CONCLUSIONS AND CLINICAL RELEVANCE: This is the first study to evaluate an ACD in semi-closed rebreathing systems. The results show that although the ACD effectively captures volatile anaesthetics at low VTs, its breakthrough increased at higher VTs.