Low flow, minimal flow and closed circuit system inhalational anesthesia in modern clinical practice
1,Department of Anesthesia and Intensive Care Azienda Ospedaliero-Universitaria Santa Maria della Misericordia Piazzale Santa Maria della Misericordia
DOI: 10.22514/SV31.022008.7 Vol.3,Issue S1,February 2008 pp.33-36
Published: 01 February 2008
Low, minimal flow and closed circuit anesthesia has been pursued since the beginning of the history of anesthesia. For many decades this form of anesthesia has been restricted to devoted enthusiasts and those very fond of gas kinetics. For most clinicians, selecting a fresh flow gas higher than 3-5 L/min was widely accepted as a routine anesthesia technique. The introduction onto the market of new volatile agents as well as advanced anesthesia machines accompanied by highly reliable monitoring systems, made minimal flow or closed system anesthesia feasible on a daily basis. Clinical, cultural, environmental, pharmacological, technological and economic reasons, force the modern anesthesiologist to reconsider the role of minimal flow and closed circuit volatile anesthesia, in clinical practice. This paper analyses the main advantages offered by these anesthesia techniques.
anesthesia, low flow, minimal flow, closed circuit, body temperature, humidification
MARCO VECIL,CRISTINA DI STEFANO,FRANCESCA ZORZI,MASSIMILIANO SALTARINI ,AMATO DE MONTE. Low flow, minimal flow and closed circuit system inhalational anesthesia in modern clinical practice. Signa Vitae. 2008. 3(S1);33-36.
1. Baum JA. Low flow anaesthesia. Butterworth Heinemann Ed. Oxford 2001.
2. Baxter AD. Low and minimal flow inhalational anaesthesia. Can J Anaesth 1997,44: 643-53.
3. Shober P, Loer SA. Closed system anaesthesia–historical aspects and recent developments. Eur J Anaesthesiol 2006;23(11):914-20.
4. Cravero J, Suida E, Manzi DJ, Rice Lj. Survey of low flow anesthesia use in the United States. Anesthesiology 1996;85:A995.
5. Tohmo H, Antila H. Increase in the use of rebreeding gas flow system and in the utilization of low flow fresh gas flows in Finnish anaesthetic practise from 1995 to 2002. Acta Anaesthesiol Scand 2005;49(3)328-30.
6. Schober P, Loer SA. An innovative anaesthesia machine: the closed system. Curr Opin Anaesthesiol 2005;18:640-4.
7. Schindler AW, Scheeren TWL, Picker O, Doehn M, Tarnow J. Accuracy of feedback controlled oxygen delivery into a closed anaesthesia circuit for measurement of oxygen consumption. Br J Anaesth 2003;90:281-90.
8. Kleemann PP. The climatisation of aesthetic gases under conditions of high flow to low flow. Acta Anaesth 1990;41;189-200.
9. Ernst E, Spain JA. Closed circuit and high flow systems: examining alternatives. In: Brown BR, Calkins JM, Sunders RJ, editors. Future anesthesia delivery systems. Contemporary anesthesia practice. Philadelphia: FA Davis Comp; 1984. p. 11-38.
10. Versichelen L, Rolly G, Vermeulen H. Accumulation of foreign gases during closed-system anaesthesia. Br J Anaesth 1996;76:668-72.
11. Korman B, Mapleson WW. Concentration and second gas effects: can the accepted explanation be improved? Br J Anaesth 1997; 78:618-25.
12. Wissing H, Kuhn I, Kessler P. Das waerme-feuchte-profil des Physioflex. Anesthesist 1997;46:201-6.
13. Stuys MM, Kalmar AF, De Baedemaeker LE. Time course of inhaled anaesthetic drug delivery using a new multifunctional closed-circuit anaesthesia ventilator. In vitro comparison with a classical anaesthesia machine. Br J Anaesth 2005;94:306-17.
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