To identify the better volatile anaesthetic delivery system in an intensive care setting, we compared the circle breathing system and two models of reflection systems (AnaConDa™ with a dead space of 100 ml (ACD-100) or 50 ml (ACD-50)). These systems were analysed for the parameters like wash-in, consumption, and wash-out of isoflurane and sevoflurane utilising a test lung model. The test lung was connected to a respirator (circle breathing system: Aisys CS™; ACD-100/50: Puriton Bennett 840). Set parameters were volume-controlled mode, tidal volume-500 ml, respiratory rate-10/min, inspiration time-2 sec, PEEP-5 mbar, and oxygen-21%. Wash-in, consumption, and wash-out were investigated at fresh gas flows of 0.5, 1.0, 2.5, and 5.0 l/min. Anaesthetic target concentrations were 0.5, 1.0, 1.5, 2.0, and 2.5%. Wash-in was slower in ACD-100/-50 compared to the circle breathing system, except for fresh gas flows of 0.5 and 1.0 l/min. The consumption of isoflurane and sevoflurane in ACD-100 and ACD-50 corresponded to the fresh gas flow of 0.5-1.0 l/min in the circle breathing system. Consumption with ACD-50 was higher in comparison to ACD-100, especially at gas concentrations > 1.5%. Wash-out was quicker in ACD-100/-50 than in the circle breathing system at a fresh gas flow of 0.5 l/min, however, it was longer at all the other flow rates. Wash-out was comparable in ACD-100 and ACD-50. Wash-in and wash-out were generally quicker with the circle breathing system than in ACD-100/-50. However, consumption at 0.5 minimum alveolar concentration was comparable at flows of 0.5 and 1.0 l/min.
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http://dx.doi.org/10.1007/s10877-020-00634-4 | DOI Listing |
J Neurodev Disord
January 2025
Rett Syndrome Research Trust, Trumbull, CT, USA.
Background: Preclinical studies and anecdotal case reports support the potential therapeutic benefit of low-dose oral ketamine as a treatment of clinical symptoms in Rett syndrome (RTT); however, no controlled studies have been conducted in RTT to evaluate safety, tolerability and efficacy.
Design: This was a sequentially initiated, dose-escalating cohort, placebo-controlled, double blind, randomized sequence, cross-over study of oral ketamine in 6-12-year-old girls with RTT to evaluate short-term safety and tolerability and explore efficacy.
Methods: Participants were randomized to either five days treatment with oral ketamine or matched placebo, followed by a nine-day wash-out period and then crossed-over to the opposite treatment.
J Asthma Allergy
December 2024
Respiratory Medicine, University Hospital of Liège, Liège, Belgium.
Introduction: Physical inactivity due to shortness of breath is common among patients with uncontrolled asthma. We evaluated the body mass composition and exercise capacity of patients with poorly controlled asthma, despite maximal inhalation therapy.
Methods: We recruited 56 patients from the Asthma Clinic of the University Hospital of Liège between September 2020 and December 2023, and 14 healthy subjects.
J Clin Anesth
February 2025
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:
Study Objective: To assess whether, in a lung resection cohort with a low probability of confounding by indication, higher FiO is associated with an increased risk of impaired postoperative oxygenation - a clinical manifestation of lung injury/dysfunction.
Design: Pre-specified registry-based retrospective cohort study.
Setting: Two large academic hospitals in the United States.
Vet Anaesth Analg
January 2025
Small Animal Hospital, University of Glasgow, School of Biodiversity, One Health and Veterinary Medicine, Glasgow, UK.
Objective: To investigate which breathing systems are available and why they are selected in dogs weighing 5-10 kg.
Study Design: Anonymous online voluntary open survey.
Methods: An online survey, designed following CHERRIES guidelines, was advertised through the American College of Veterinary Anesthesiologists - List, Association of Veterinary Anaesthesia and European College of Veterinary Anaesthesia and Analgesia (February-March 2022).
A A Pract
December 2024
From the Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.
The circle breathing system enables rebreathing using a carbon dioxide absorbent. This case report presents a rare incident of ventilation failure in a 30-year-old male patient due to a broken unidirectional valve in a soda lime canister. Despite the anesthesia machine passing automated checks, a mechanical blockage from caked soda lime in the inner inspiratory chamber led to insufficient tidal volume delivery.
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