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ENGLISH ABSTRACT
JOURNAL ARTICLE
REVIEW
[Anesthesia equipment: fresh gas delivery systems. I. Mecanical systems with rotameters and calibrated vaporizers].
Annales Françaises D'anesthèsie et de Rèanimation 1999 November
OBJECTIVES: To analyse the design, performance, failures, the checking before use of mechanical fresh gas delivery units (FGDUs) equipped with bobbin or ball-flowmeters delivering a continuous gas flow and calibrated vaporizers, marketed in France in 1999.
DATA SOURCES: Articles were obtained from a Medline review (1960-1999; search terms: anaesthetic machine, flowmeter, vaporizer), textbooks and personal files; specific data were provided by manufacturers.
STUDY SELECTION AND DATA EXTRACTION: The articles were considered for performance data, benefits and drawbacks, and characteristics, as well as the risks carried by mechanical FGDUs.
DATA SYNTHESIS: Seven anaesthetic machines out of 11 are equipped with mechanical FGDUs, including rotameters delivering a gas mixture up to 30 L.min-1, calibrated vaporizers and an O2-flush valve delivering at least 500 mL O2 per second (30 L.min-1). These units allow closed circuit anaesthesia. They carry a risk for barotrauma as three out of them can deliver at the gas outlet of the FGDUs a gas mixture at a pressure reaching 3.5 bars and four others at a pressure of 150-200 mmHg. They also carry a risk for hypoxia, either from a preferential leak of oxygen at the corresponding rotameter or the O2-flush valve, or from a leak of fresh gas mixture either in a vaporizer or the selectatec manifold. The vaporizers carry a risk for vapor delivery at a concentration differing notably from the value set on the concentration dial. Therefore their accuracy must be checked periodically and the FGDUs checked for a leak after the addition to or the removal of a vaporizer from the selectatec manifold. The optimal technique for leak detection is the negative pressure test.
DATA SOURCES: Articles were obtained from a Medline review (1960-1999; search terms: anaesthetic machine, flowmeter, vaporizer), textbooks and personal files; specific data were provided by manufacturers.
STUDY SELECTION AND DATA EXTRACTION: The articles were considered for performance data, benefits and drawbacks, and characteristics, as well as the risks carried by mechanical FGDUs.
DATA SYNTHESIS: Seven anaesthetic machines out of 11 are equipped with mechanical FGDUs, including rotameters delivering a gas mixture up to 30 L.min-1, calibrated vaporizers and an O2-flush valve delivering at least 500 mL O2 per second (30 L.min-1). These units allow closed circuit anaesthesia. They carry a risk for barotrauma as three out of them can deliver at the gas outlet of the FGDUs a gas mixture at a pressure reaching 3.5 bars and four others at a pressure of 150-200 mmHg. They also carry a risk for hypoxia, either from a preferential leak of oxygen at the corresponding rotameter or the O2-flush valve, or from a leak of fresh gas mixture either in a vaporizer or the selectatec manifold. The vaporizers carry a risk for vapor delivery at a concentration differing notably from the value set on the concentration dial. Therefore their accuracy must be checked periodically and the FGDUs checked for a leak after the addition to or the removal of a vaporizer from the selectatec manifold. The optimal technique for leak detection is the negative pressure test.
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