20.500.12556/DKUM-65275 Interakcija med absorbentom CO2 in lahkohlapnim anestetikom v krožnem anestezijskem dihalnem sistemu Interaction between carbon dioxide absorbents and volatile anaesthetics in a closed anaesthesia breathing system Izhodišča: Izsušenost zrnc absorbenta v absorberju ogljikovega dioksida (CO2) v anestezijskem dihalnem sistemu (ADS) povzroča odstopanje med želeno (odbrano) in dejansko (izmerjeno) vrednostjo lahkohlapnega anestetika; izmerjena vrednost je manjša od odbrane, zato bolnika težko uvedemo v anestezijo. Poleg tega pa zaradi zapletene interakcije med zrnci v absorberju in anestetikom v ADS nastajajo strupeni plini, ki jih ne moremo zaznati s standardnim merjenjem spremenljivk med anestezijo. Namen prispevka je preveriti, ali zdravstveno osebje, ki skrbi za zamenjavo zrnc v absorberju, pozna ta problem, in podati smernice za njegovo preprečevanje. Metode: V deskriptivni študiji smo podatke zbrali z anketnim vprašalnikom odprtega tipa. Pilotsko raziskavo smo izvedli na vzorcu 25 anestezijskih medicinskih sester iz petih slovenskih splošnih bolnišnic, kjer se izvajajo operativni posegi v splošni anesteziji. Rezultati: Ugotovili smo, da je 92 % udeležencev raziskave že opazilo neskladja med odbrano in izmerjeno koncentracijo anestetika, ki je nihala med 10 % in 50 %. Velik delež anketiranih anestezijskih medicinskih sester (64 %) ne razmišlja, da bi lahko bil vzrok v absorberju. Samo en odgovor v anketnem vprašalniku je omenjal pravi vzrok težav – izsušena zrnca v absorberju. Smernice za zamenjavo zrnc v absorberju se med bolnišnicami razlikujejo, tako da se absorbent zamenjuje v različnih intervalih. Razpravljanje: Pravi vzrok večjega odstopanja koncentracij anestetika zaradi izsušitve večini anketirancev ni znan. Izsuševanje zrnc v absorberju lahko preprečimo z ustrezno pripravljenimi smernicami, v katerih poskrbimo za zamenjavo absorbenta v ustreznih intervalih in ob pravem času. Background: Desiccation of the carbon dioxide (CO2) absorbent in an anaesthetic breathing system results in a discrepancy between the desired (selected) and actual (measured) levels of volatile anaesthetic; the measured value is lower than the selected value, which may make the induction of anaesthesia difficult. Moreover, because of a complicated interaction between the absorbent and the anaesthetic agent, toxic gases are formed within the system, which cannot be detected by standard monitoring during anaesthesia. The aim of this study was to check if the personnel responsible for changing the absorbent are aware of this problem, and to provide guidelines for its prevention. Method: A descriptive pilot study was conducted on a sample of 25 anaesthesia nurses from five Slovene hospitals performing surgical procedures under general anaesthesia. Data was gathered with an open-type questionnaire. Results: We found that 92 % of the study participants had noticed discrepancies between the selected and measured levels of anaesthetic agent inthe breathing system, which ranged between 10% and 50%. A large proportion of the nurses (64%) did not consider CO2 absorber to be a possible source of the observed discrepancies. Only one nurse knew that the problem was caused byabsorbent desiccation. Guidelines for absorbent replacement vary among hospitals, and so absorbents are changed at different intervals. Conclusion: The majority of nurses in our study were not aware that absorbent desiccation can significantly reduce the level of volatile anaesthetics in the breathing system. The problem can be prevented by adopting appropriate guidelines, which guarantee that absorbents are changed regularly as required. anestezijski aparat anestezijski dihalni sistem absorber CO2 izsušitev absorbenta anesthesia machine anesthesia breathing system CO2 absorbents absorbent desiccation true false true Slovenski jezik Angleški jezik Znanstveno delo 2017-03-28 10:00:43 2017-03-28 10:02:15 2022-07-07 03:09:03 2019-07-11 15:13:09 2011 0 0 str. 820-823 št. 11 Letn. 80 nov. 2011 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 1318-0347 617 32893696 29115097 1318-0347 URN:SI:UM:DK:ONM35VZM Zdravniski_vestnik_2011_Krizmaric,_Manohin_Interakcija_med_absorbentom_CO2_in_lahkohlapnim_anestetikom_v_kroznem_anestezijskem_dihalnem.pdf Zdravniski_vestnik_2011_Krizmaric,_Manohin_Interakcija_med_absorbentom_CO2_in_lahkohlapnim_anestetikom_v_kroznem_anestezijskem_dihalnem.pdf 1 66B8D73E5DF135BC37B7315B87A9765C 01131505dad03d646e7eb8327c1ad9a525acbb1875208b48cb8bfe3a4d7e6a72 06ce4c2c-7c0e-11eb-bb7a-00155d0001ca https://dk.um.si/Dokument.php?lang=slv&id=110235 http://vestnik.szd.si/index.php/ZdravVest/article/view/209 1 https://dk.um.si/Dokument.php?lang=slv&id=110234 Medicinska fakulteta 0 0 0