ARDS: extrakorporale CO2-Elimination sicher und wirksam?

2019 ◽  
Vol 54 (09) ◽  
pp. 513-514
Keyword(s):  
Co2 Elimination

Effects of the Water Content of Soda Lime on Compound A Concentration in the Anesthesia Circuit in Sevoflurane Anesthesia 

1998 ◽  
Vol 88 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Hiromichi Bito ◽  
Yukako Ikeuchi ◽  
Kazuyuki Ikeda
Keyword(s):  
Gas Flow ◽  
Soda Lime ◽  
Absorption Capacity ◽  
Low Flow ◽  
Co2 Absorption ◽  
Sevoflurane Anesthesia ◽  
Compound A ◽  
Carbon Dioxide Co2 ◽  
End Tidal ◽  
Co2 Elimination

Background Sevoflurane anesthesia is usually performed with fresh gas flow rates greater than 2 l/min due to the toxicity of compound A in rats and limited clinical experience with sevoflurane in low-flow systems. However, to reduce costs, it would be useful to identify ways to reduce compound A concentrations in low-flow sevoflurane anesthesia. This goal of this study was to determine if compound A concentrations can be reduced by using soda lime with water added. Methods Low-flow sevoflurane anesthesia (fresh gas flow of 1 l/min) was performed in 37 patients using soda lime with water added (perhydrated soda lime) or standard soda lime as the carbon dioxide (CO2) absorbent. The soda lime was not changed between patients, but rather was used until CO2 rebreathing occurred. The perhydrated soda lime was prepared by spraying 100 ml distilled water onto 1 kg fresh soda lime, and water was added only when a new bag of soda lime was placed into the canister. Compound A concentrations in the circle system, soda lime temperatures, inspired and end-tidal CO2 and end-tidal sevoflurane concentrations, and CO2 elimination by the patient were measured during anesthesia. Results Compound A concentrations were significantly lower for the perhydrated soda lime (1.9 +/- 1.8 ppm; means +/- SD) than for the standard soda lime (13.9 +/- 8.2 ppm). No differences were seen between the two types of soda lime with regard to the temperature of the soda lime, end-tidal sevoflurane concentrations, or CO2 elimination. Compound A concentration decreased with the total time of soda lime use for both types of soda lime. The CO2 absorption capacity was significantly less for perhydrated soda lime than for standard soda lime. Conclusions Compound A concentrations in the circuit can be reduced by using soda lime with water added. The CO2 absorption capacity of the soda lime is reduced by adding water to it, but this should not be clinically significant.

Analysis of PCO2 differences during rebreathing due to slow pH equilibration in blood

1978 ◽  
Vol 45 (5) ◽  
pp. 666-673 ◽  
Author(s):  
A. Bidani ◽  
E. D. Crandall
Keyword(s):  
Quantitative Analysis ◽  
Gas Exchange ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Transport Processes ◽  
O2 Uptake ◽  
Lung Capillaries ◽  
Mixed Venous ◽  
Co2 Elimination

A quantitative analysis of the reaction and transport processes that occur in blood during and after gas exchange has been used to investigate mechanisms that might account for positive alveolar-mixed venous (A-V) and alveolar-arterial (Aa) PCO2 differences during rebreathing. The analysis was used to determine PCO2 changes that take place in blood as it travels from veins to arteries under conditions in which no CO2 is exchanged in the lung. The predicted A-V and Aa PCO2 differences are all positive and lie within the range of reported measured values. The differences are due to disequilibrium of [H+] between plasma and red blood cells, and to disequilibrium of the reactions CO2 in equilibrium HCO3- + H+ in plasma, as blood leaves the tissue and/or lung capillaries. The differences are increased with exercise and with continued O2 uptake in the lung, the latter due to the Haldane shift. We conclude that the two disequilibria and the Haldane shift contribute to the reported PCO2 differences in rebreathing animals but may not fully account for them. These mechanisms cannot explain any PCO2 differences that might exist during net CO2 elimination from blood in the lung.

Chloral Hydrate and the Carbon Dioxide Chemoreceptor Response: A Study of Puppies and Infants

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 447-450
Author(s):  
Martin H. Lees ◽  
George D. Olsen ◽  
Kip L. McGilliard ◽  
James D. Newcomb ◽  
Cecille O. Sunderland
Keyword(s):  
Carbon Dioxide ◽  
Tidal Volume ◽  
Eye Movement ◽  
Chloral Hydrate ◽  
Nrem Sleep ◽  
Co2 Production ◽  
O2 Consumption ◽  
Rapid Eye Movement ◽  
Natural Sleep ◽  
Co2 Elimination

CO2 chemoreceptor function was assessed during natural sleep and following the administration of 100 mg/kg of chloral hydrate to 26 puppies. With chloral hydrate-induced sleep, there were no significant changes in ventilation or in CO2 chemoreceptor response. The ventilation and CO2 chemoreceptor response of a group of infants in natural sleep were compared with those of a group receiving 50 mg/kg of chloral hydrate. Tidal volume, O2 consumption, and CO2 elimination were slightly higher in the group given chloral hydrate. There was no difference in the CO2 chemoreceptor response. The proportion of time spent in rapid eye movement (REM) and non-rapid eye movement (NREM) sleep in chloral hydrate-induced sleep was similar to that occurring in natural sleep. Use of chloral hydrate stabilizes O2 consumption and CO2 production, and it greatly facilitates the assessment of chemoreceptor function in infants. The CO2 chemoreceptor response appears not to be altered in puppies or infants.

Extrakorporale CO2-Elimination zur Behandlung der respiratorischen Insuffizienz

1993 ◽  
pp. 63-75
Author(s):  
M. Knoch ◽  
E. E. Müller ◽  
W. Höltermann
Keyword(s):  
Co2 Elimination
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