Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 2018
Randomized Controlled TrialDesflurane usage during anesthesia with and without N2O using FLOW-i Automatic Gas Control with three different wash-in speeds.
AGC® (Automatic Gas Control) is the FLOW-i's automated low flow tool (Maquet, Solna, Sweden) that target controls the inspired O2 (FIO2) and end-expired desflurane concentration (FAdes) while (by design) exponentially decreasing fresh gas flow (FGF) during wash-in to a maintenance default FGF of 300 mL min-1. It also offers a choice of wash-in speeds for the inhaled agents. We examined AGC performance and hypothesized that the use of lower wash-in speeds and N2O both reduce desflurane usage (Vdes). ⋯ AGC performance for O2 and desflurane targeting is excellent. After 1 h, the wash-in speeds tested are unlikely to affect desflurane usage. N2O usage decreases Vdes proportionally with its reduction in FAtdes.
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J Clin Monit Comput · Aug 2018
Randomized Controlled Trial Comparative StudyUse of the MIRUS™ system for general anaesthesia during surgery: a comparison of isoflurane, sevoflurane and desflurane.
The MIRUS™ system enables automated end-expired control of volatile anaesthetics. The device is positioned between the Y-piece of the breathing system and the patient's airway. The system has been tested in vitro and to provide sedation in the ICU with end-expired concentrations up to 0.5 MAC. ⋯ The MIRUS™ system reliable delivers 1.0 MAC of the modern inhaled agents, both during mechanical ventilation and spontaneous (assisted) breathing. Agent usage is highest with desflurane (highest MAC) but results in the fastest emergence. Trial registry number: Clinical Trials Registry, ref.: NCT0234509.