Background: Tidal volume (V(T)) must be accurately delivered by anaesthesia ventilators in the volume-controlled ventilation mode in order for lung protective ventilation to be effective. However, the impact of fresh gas flow (FGF) and lung mechanics on delivery of V(T) by the newest anaesthesia ventilators has not been reported.
Methods: We measured delivered V(T) (V(TI)) from four anaesthesia ventilators (Aisys™, Flow-i™, Primus™, and Zeus™) on a pneumatic test lung set with three combinations of lung compliance (C, ml cm H2O(-1)) and resistance (R, cm H2O litre(-1) s(-2)): C60R5, C30R5, C60R20. For each CR, three FGF rates (0.5, 3, 10 litre min(-1)) were investigated at three set V(T)s (300, 500, 800 ml) and two values of PEEP (0 and 10 cm H2O). The volume error = [(V(TI) - V(Tset))/V(Tset)] ×100 was computed in body temperature and pressure-saturated conditions and compared using analysis of variance.
Results: For each CR and each set V(T), the absolute value of the volume error significantly declined from Aisys™ to Flow-i™, Zeus™, and Primus™. For C60R5, these values were 12.5% for Aisys™, 5% for Flow-i™ and Zeus™, and 0% for Primus™. With an increase in FGF, absolute values of the volume error increased only for Aisys™ and Zeus™. However, in C30R5, the volume error was minimal at mid-FGF for Aisys™. The results were similar at PEEP 10 cm H2O.
Conclusions: Under experimental conditions, the volume error differed significantly between the four new anaesthesia ventilators tested and was influenced by FGF, although this effect may not be clinically relevant.
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http://dx.doi.org/10.1093/bja/aes594 | DOI Listing |
Anesth Crit Care
October 2024
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona CA 91766, USA.
Anesthesiologists and the critical care team may be at increased risk of contracting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, COVID-19) due to airway manipulations and intubations performed during anesthesia administration and management of patient undergoing surgery. SARS-CoV-2 infections have been reported among healthcare workers. The virus is transmitted by close personal contact and aerosols.
View Article and Find Full Text PDFSemin Liver Dis
January 2025
Hepatology, University of Pennsylvania, Philadelphia, United States.
Critically ill patients with cirrhosis and liver failure not uncommonly have hypotension due to multifactorial reasons, that include hyperdynamic state with increased cardiac index, low systemic vascular resistance due to portal hypertension, following the use of beta blocker or diuretic therapy, and severe sepsis. These changes are mediated by microvascular alterations in the liver, systemic inflammation, activation of renin angiotensin aldosterone system, and vasodilatation due to endothelial dysfunction. Hemodynamic assessment includes measuring inferior vena cava indices, cardiac output and systemic vascular resistance using point-of-care ultrasound (POCUS), in addition to arterial waveform analysis, or pulmonary artery pressures, and lactate clearance to guide fluid resuscitation.
View Article and Find Full Text PDFAnn Intensive Care
January 2025
Department of Intensive Care Unit, Yanbian University Hospital, No. 1327, Juzi Street, Xinxing Street, Yanji, 136200, Jilin, China.
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View Article and Find Full Text PDFInfect Prev Pract
March 2025
Cardio Thoracic and Vascular Surgery, PGIMER, Chandigarh, India.
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BMJ Open
December 2024
Department of Anesthesiology, Peking University First Hospital, Beijing, China
Objective: To investigate the impact of dexmedetomidine-ropivacaine combination versus sufentanil-ropivacaine combination for epidural labour analgesia on neonatal and maternal outcomes and test the feasibility of a future large, randomised trial.
Design: A randomised, double-blind, pilot clinical trial from 16 March 2023 to 15 June 2023.
Setting: A tertiary-care hospital in Beijing, China.
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