Performance of an active inspired hypoxic guard

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• 作者：Idris E. Ghijselings ; Sofie De Cooman…
• 关键词：Machine standards ; Hypoxic guard system ; Hypoxia ; Hypoxic mixtures
• 刊名：Journal of Clinical Monitoring and Computing
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：30
• 期：1
• 页码：63-68
• 全文大小：539 KB
• 参考文献：1.Dorsch JA, Dorsch SE. Understanding anesthesia equipment. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 108–10.
  2.ASTM (American Society for Testing and Materials) Standard F1850-00, clause 51.13.1 Protection Against Accidental Delivery of Hypoxic Gas Mixtures.
  3.International Organization for Standardization (ISO) and the International Electrotechnical Commission (IEC) Standard EN60601-2-13, clause 51.102.2 Anaesthetic gas delivery system.
  4.De Cooman S, Schollaert C, Hendrickx JF, Peyton PJ, Van Zundert T, De Wolf AM. Hypoxic guard systems do not prevent rapid hypoxic inspired mixture formation. J Clin Monit Comput. 2014 Oct 1, published ahead of print.
  5.User’s Manual FLOW-i 4.0 Anesthesia System, Infologic 1.58. Maquet Getinge group, p. 66–7.
  
• 作者单位：Idris E. Ghijselings (1)
  Sofie De Cooman (2)
  Rik Carette (1)
  Philip J. Peyton (3)
  Andre M. De Wolf (4)
  Jan F. A. Hendrickx (1)
  
  1. Department of Anesthesiology, Intensive Care and Pain Therapy, OLV Hospital, Aalst, Belgium
  2. Department of Anesthesiology, Sint-Jan Clinic, Brussels, Belgium
  3. Department of Anesthesia, Austin Hospital and University of Melbourne, Melbourne, Australia
  4. Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Anesthesiology
  Intensive and Critical Care Medicine
  Statistics for Life Sciences, Medicine and Health Sciences
  
• 出版者：Springer Netherlands
• ISSN：1573-2614

文摘

Current hypoxic guards systems fail to maintain the inspired O₂ concentration (F_IO₂) ≥ 21 % across the entire fresh gas flow (FGF) range when a second carrier gas is used (N₂O or air). We examined the performance of the Maquet O₂ Guard®, a smart hypoxic guard that increases O₂ delivery if an inspired hypoxic mixture is formed. After obtaining IRB approval and informed consent, 12 ASA I-II patients were enrolled. During anesthesia with sevoflurane in O₂/air, the O₂ Guard® was tested by administering O₂/air at the following delivered hypoxic guard limits [expressed as (total FGF in L min−1; F_DO₂ in %)] for 4 min each: [0.3;67], [0.4;50], [0.6;34], [0.8;25], [1.0;21], [1.2;21], [1.5;21], [2;21], [3;21], and [5;21]. The following data were collected: (1) time from F_IO₂ = 30 to 20 %; (2) time from F_IO₂ = 20 % to O₂ Guard® activation; (3) time from O₂ Guard® activation to F_IO₂ = 25 %; (4) FGF and F_DO₂ used by the O₂ Guard. If SpO₂ was <90 % for 10 s or longer at any time, the patient was excluded. Three patients were excluded for low SpO₂. The incidence of F_IO₂ < 21 % was 100 % within the 1–2 L min−1 FGF range. The O₂ Guard® was activated within 20 s after F_IO₂ became 20 %, except in one patient where F_IO₂ oscillated between 20 and 21 %. F_DO₂ was increased to 60 % and FGF to 1 L min−1 (the latter only if it was lower than 1 L min−1 prior to activation of the O₂ Guard). F_IO₂ increased to 25 % within 55 s after O₂ Guard activation in all patients. The O₂ Guard®, an active inspired hypoxic guard, rapidly reverses and limits the duration of inspired hypoxic episodes when the delivered hypoxic guard fails to do so. Keywords Machine standards Hypoxic guard system Hypoxia Hypoxic mixtures