Sevoflurane consumption with the Flow-i ventilator in two versions of automatic gas control algorithms and two settings of manually controlled anesthesia : an economic and ecological assessment
Year: 2020
Type: article
Study design: Observational Study
Abstract: Volatile anesthetics have long-lived greenhouse gas properties. These molecules undergo virtually no biotransformation in vivo, so in a single patient they can be recirculated in the closed-circuit system or expelled into the atmosphere. In this respect, manufacturers of modern-day anesthesia machines have developed automated target control low-flow tools for proficient volatile delivery. Volatile agent consumption at the Maria Middelares Hospital, Ghent, within four defined flow control groups was observed retrospectively by chronologically assigning the first 25 encountered patients (who met inclusion criteria) to their respective group. In these groups. either (1) a Minimal (300 mL min(-1)) or (2) a 2-liter FGF (2L FGF) ; (3) AGC(V4)(.)(04) or the newer (4) AGC(V4)(.)(07) was used to provide sustainable anesthesia. Digitalized data was extracted and visualized for each case. Average (standard deviation ; SD) consumption was calculated at 5 minutes intervals. After 45 minutes, the average (SD) consumption of sevoflurane was 14,4 (1,3) ; 5 (1,2) ; 7 (1,4) ; and 6,3 (1,3) mL in the 2L FGF; Minimal ; AGC(V4)(.)(04)degrees and AGC(V4)(.)(07) group, respectively. Compared to Minimal, AGC degrees groups consumed significantly more sevoflurane at the early stage of anesthesia, but then decreased to a comparable rate. Our results indicate that manually regulated minimal flow is more economic and ecological, compared to AGC degrees. Conventional "low-flow anesthesia" practice (e.g. 2L-FGF) should be aborted as AGC degrees offers a vital solution to the opposing stakes of ecological/economic concerns and stability/ease of anesthetic delivery, but the algorithms should be furtherly optimized. Timely upgrade towards most recent software versions can deliver significant cost savings and a reduction of the ecological footprint.
Source: Lirias
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7033833603