20.500.12556/DKUM-52154 Analiza pretokov dihalne zmesi skozi krožne anestezijske dihalne sisteme in njihov vpliv na izsušenost zrnc absorberja CO2 The analysis of fresh gas flow in a circle anaesthetic breathing system, and its influence on CO2 absorbent desiccation Izhodišča: Če na anestezijskem aparatu ob koncu anestezije pozabimo zapreti pline, ti kontinuirano tečejo skozi anestezijski dihalni sistem (ADS) in lahko izsušijo absorbent v absorberju. Ob začetku naslednje anestezije izsušeni absorbent razgradi lahkohlapni anestetik in tako nastajajo strupene zmesi, ki so nevarne za bolnika. Tedaj se razlikujeta tudi odbrana in izmerjena vrednost lahkohlapnega anestetika. V prispevku analiziramo potencialno nevarne možne smeri kontinuiranega pretoka dihalne zmesi skozi različne ADS. Metode: V prvem delu raziskave smo z eksperimentalno metodo simulirali kontinuirani pretok dihalne zmesi na anestezijskem aparatu Sulla. V drugem delu smo analizirali, ali so mogoči retrogradni pretoki skozi absorber pri konvencionalnem ADS in anestezijskih aparatih Fabius GS, Cato, Julian in Primus pri zaprtem oziroma odprtem nastavku Y. Stopili smo v stik s servisno službo proizvajalca anestezijskih aparatov, da bi nam posredovali informacije, ali uporabniki zaradi neujemanja odbranih in izmerjenih koncentracij anestetika potrebujejo serviserja. Rezultati: Skozi ADS Dräger ISO 8 (anestezijski aparat Sulla) ni mogoč retrogradni pretok pri standardnem priključku dovoda svežih plinov. Absorbent se suši v primeru odprtega ali zaprtega nastavka Y pri kontinuiranem pretoku. Pri anestezijskem aparatu Sulla je možen retrogradni pretok samo pri tistih aparatih, pri katerih je dovod svežega plina nameščen pod inspiracijsko zaklopko. Retrogradni pretoki, ki sušijo zrnca absorbenta v absorberju, so mogoči pri anestezijskih aparatih Cato, Julian, Fabius GS in Primus pri zaprtem nastavku Y. Serviserji opozarjajo na težave, ki se dogajajo predvsem ob ponedeljkih zjutraj, pred prvo anestezijo. Zaključki: Po zaključeni anesteziji moramo vedno zapreti dovode svežih plinov na anestezijskem aparatu. Pozorni moramo biti na absorbent, predvsem pri starejših anestezijskih aparatih in pred prvo anestezijo ob ponedeljkih. Pri anestezijskih aparatih novejše generacije moramo paziti, da je ventil za urgentno predihavanje (Safety O2) po koncu anestezije zaprt. Background: If at the end of anaesthesia, the gases on the anaesthetic machineare not turned off, they continue to flow through the breathing circuitand may dry out the carbon dioxide absorbent in the absorber. At the beginning of the next anaesthetic procedure, the desiccated absorbent decomposes the volatile anaesthetic, resulting in the formation of toxic gas mixtures, which are dangerous for the patient. In such circumstances, the measured level of the volatile anaesthesic in the breathing circuit differs from the selected value. In the paper, we analyse potentially dangerous possible directions of continuous flow of fresh gas mixture in different anaesthetic breathing circuits. Methods: In the first part of the study, we simulated the continuous flow of gases in a Sulla anaesthesia machine using anexperimental method in a simulation setting. In the second part, we analysedwhether a retrograde flow through the absorber was possible in a convential anaesthetic breathing circuit and in the Fabius GS, Cato, Julian and Primus circuits with the Y-piece connector open or closed. Information on users' requests for maintenance services due to discrepancies between the desired and measured levels of the volatile anaesthetic in the breathing circuit were obtained from the manufacturer's local servicing agent. Results: In a Draeger ISO 8 circle system (Sulla anaesthetic machine) with a standard gas supply connector, a retrograde flow is not possible. If the Y-piece connector is left open, the gases are vented to the outside via the absorber and the inspiratory tube. If the Y-piece connector is closed or open, the absorbent in the canister dries because of the continuous flow of gas. A retrograde flow is possible only in those Sulla anaesthetic machines where the fresh gas inlet is located below the inspiratory valve. A retrograde flow of gases causing absorbent desiccation can occur in a Cato, Julian, Fabius GS, or Primus anaesthetic machines with the Y-piece connector closed. Maintenance engineers point out that problems are reported mostly on Monday mornings before the first operation. Conclusions: Aſter completed anaesthesia, the fresh gas inlets on the anaesthetic machine must always be closed. Especially in older machines, the carbon dioxide absorber must be checked before the first operation on a Monday morning. In new-generation machines, we must make sure that the emergency ventilation valve is closed af- ter the end of anaesthesia. anestezijski aparat anestezijski dihalni sistem absorber CO2 izsušitev (desikacija) absorberja anaesthesia machine anaesthetic breathing system carbon dioxide absorber absorbent desiccation true false true Slovenski jezik Angleški jezik Znanstveno delo 2015-07-10 17:08:29 2015-07-10 17:08:30 2022-05-31 03:09:29 2021-05-10 03:11:08 2012 0 0 str. 341-348 št. 4 Letn. 81 2012 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 1318-0347 616-089.5:615.4 32893696 29812441 1318-0347 URN:SI:UM:DK:VLRR4OFY Zdravniski_vestnik_2012_Krizmaric,_Manohin_Analiza_pretokov_dihalne_zmesi_skozi_krozne_anestezijske_dihalne_sisteme_in_njihov_vpliv_na_i.pdf Zdravniski_vestnik_2012_Krizmaric,_Manohin_Analiza_pretokov_dihalne_zmesi_skozi_krozne_anestezijske_dihalne_sisteme_in_njihov_vpliv_na_i.pdf 1 A609E6EA581A9CFAE535E9FADAF102C4 26b4d971ddb060f3bf7080c0a5e08766f129192f4ca9b0f854d17c03ae8d096d 07e9ca8b-7c0e-11eb-bb7a-00155d0001ca https://dk.um.si/Dokument.php?lang=slv&id=110273 http://vestnik.szd.si/index.php/ZdravVest/article/view/812 1 https://dk.um.si/Dokument.php?lang=slv&id=110272 Medicinska fakulteta 0 0 0