Sedierung mit volatilen Anästhetika auf der Intensivstation: Technische Umsetzung und aktuelle Möglichkeiten der Restgasfilterung (original) (raw)

Krankenhaus-Hygiene + Infektionsverhütung, 2007

Abstract

ABSTRACT The routine use of volatile anesthetics in intensive care medicine has been limited so far due to technical difficulties and the need for an anaesthetic machine. The new Anesthetic Conserving Device (AnaConDa®) is a modified heat and moisture exchanger which includes activated carbon fibres. It works as a miniaturized vapor with recirculation facilitating the use of volatile anesthetic for long-term sedation with any classical ventilator. The Anaesthetic Conserving Device (AnaConDa®-System) replaces the common heat and moisture exchanger in the ventilator circuit. The volatile anaesthetic is continuously applied in liquid status via a syringe pump to the minivapor where the anesthetic is vaporized. The expired anaesthetic gas is stored in the carbon filter and about 90% are resupplied into the breathing circle. Beside the active central hospital scavenging system actual three passive scavenging systems with different modified activated charcoal can be used for anaesthesia gas scavenging from the ventilator. Current studies have experienced a safe application route, no development of tolerance as well as short wake-up times after long-term sedation with volatile anaesthetics. There is still need for studies on economical aspects. The current experiences suggest that volatile anaesthetics present an alternative for long-term sedation on intensive care units, providing optimized pathways from a medical as well as from an economical viewpoint. According to current drug-approval-laws the use of volatile anaesthetics for a longer period is an off-label use and should only be applied by medical professionals at their own responsibility.

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