Publication: Anestesia cuantitativa: influencia del tamaño corporal en la eficacia de un nuevo dispositivo para la administración de anestésicos halogenados en circuitos cerrados
Loading...
Files
Official URL
Full text at PDC
Publication Date
2016-04-11
Authors
Advisors (or tutors)
Waxman Dova, Samanta
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad Complutense de Madrid
Citations
Exportar
Abstract
Los métodos tradicionales de vaporización de líquidos anestésicos volátiles están compuestos por vaporizadores que se ubican fuera del circuito anestésico y movilizan el vapor impulsado por una columna de gas diluyente, generalmente el oxígeno. La casi totalidad de las máquinas anestésicas emplean este método de vaporización conocido como VOC (por sus siglas en inglés, Vaporizer Outside the Circuit). Cuando se emplea un vaporizador ubicado fuera del circuito, el volumen de vapor anestésico incorporado al sistema depende del flujo de gas fresco que atraviesa el vaporizador, es decir que es directamente proporcional a él. El volumen de gas fresco necesario para incorporar la dosis de vapor adecuado para cada fase del ciclo anestésico genera un exceso de volumen que debe ser eliminado del circuito minuto a minuto. Esta es la razón por la cual, cuando se emplea este método de vaporización no se puede cerrar el circuito anestésico, lo cual conlleva a un consumo excesivo de anestésico. Esto tiene consecuencias sobre el costo del procedimiento, la contaminación del ambiente de trabajo y del medio ambiente y en cierta medida también sobre el paciente. La mayor desventaja que presenta reducir el flujo de gas fresco es que aumenta el tiempo necesario para promover cambios en la concentración anestésica del circuito. La forma más sencilla de resolver este inconveniente es emplear métodos de vaporización que se independicen de la columna de gas fresco para incorporar el vapor anestésico. El objetivo del presente estudio fue diseñar y evaluar la eficacia de un sistema de vaporización que permita cerrar el circuito anestésico desde el inicio del procedimiento, reduciendo al máximo el consumo, sin limitar el volumen de vapor a incorporar al sistema...
When working with a vaporizer located outside the breathing circuit, the anesthetic vapour delivered into the system is dependent on fresh gas flow (FGF). This may be a major disadvantage for the complete closure of the anesthetic circuit. Also, when using low flow anesthesia, another disadvantage may be the difficulty in producing rapid changes in the anesthetic effect without FGF adjustments, due to the long time constant of the low flow circuits. Flow-independent delivery of volatile agents is an excellent alternative for overcoming these difficulties. Standard methods are placing the vaporizer inside the circuit (VIC) or injecting a calculated volume of the liquid agent directly into the circuit. The purpose of this study was to design and to evaluate the efficacy of a fresh gas flow independent-system that allows closing the anesthetic circuit from the begining of the procedure without restricting the volume of anesthetic vapour delivered to the system and minimizing drug consumption. In order to do so, a pump that propels the patient circle system gases in a continuous flow through a standard vaporizer (vaporizer outside the circuit, VOC) was introduced. The circulating flow, which is now a mixture of the anesthetic gas and the exhaled gases (after CO2 has been removed by the absorbent), is used to make the vaporizer work, thus the vaporizer is independent of the fresh gas flow. With this method, we can provide a quantitative anesthesia, adapting the gases delivery to the patient’s requirements. Oxygen is provided by a flowmeter calibrated to deliver the patient’s metabolic uptake...
When working with a vaporizer located outside the breathing circuit, the anesthetic vapour delivered into the system is dependent on fresh gas flow (FGF). This may be a major disadvantage for the complete closure of the anesthetic circuit. Also, when using low flow anesthesia, another disadvantage may be the difficulty in producing rapid changes in the anesthetic effect without FGF adjustments, due to the long time constant of the low flow circuits. Flow-independent delivery of volatile agents is an excellent alternative for overcoming these difficulties. Standard methods are placing the vaporizer inside the circuit (VIC) or injecting a calculated volume of the liquid agent directly into the circuit. The purpose of this study was to design and to evaluate the efficacy of a fresh gas flow independent-system that allows closing the anesthetic circuit from the begining of the procedure without restricting the volume of anesthetic vapour delivered to the system and minimizing drug consumption. In order to do so, a pump that propels the patient circle system gases in a continuous flow through a standard vaporizer (vaporizer outside the circuit, VOC) was introduced. The circulating flow, which is now a mixture of the anesthetic gas and the exhaled gases (after CO2 has been removed by the absorbent), is used to make the vaporizer work, thus the vaporizer is independent of the fresh gas flow. With this method, we can provide a quantitative anesthesia, adapting the gases delivery to the patient’s requirements. Oxygen is provided by a flowmeter calibrated to deliver the patient’s metabolic uptake...
Description
Tesis inédita de la Universidad Complutense de Madrid, Facultad de Veterinaria, Departamento de Toxicología y Farmacología, leída el 06-11-2015