2. When did organ music become associated with baseball? The results for canister T°inand T°outare shown in figure 2. A difference in absorption of sevoflurane in the used absorbents (standard hydrated, not dry in our setup) might be another possibility because Stabernack et al. To simulate the oxygen consumption of a patient, a continuous flow of the gas mixture containing oxygen and carbon dioxide was taken out at a flow rate of approximately 200 ml/min at the T-piece fixed at the outlet of the test lung. In experimental conditions the formation of compound A was reportedly less with KOH-free soda limes, 3which were then produced by various companies, and alternate NaOH-free and KOH-free carbon dioxide absorbents became available. 4However, in that study, 30-ml syringes immersed in water at a constant temperature of 45°C were used, whereas in our setup we have an artificial lung with carbon dioxide production, which comes close to clinical conditions and in which the canister temperature was a function of the actual carbon dioxide binding process. A plausible hypothesis that less sevoflurane was broken down by the non–compound A–producing Amsorb, has to be rejected because with the other non–compound A–producing lithium hydroxide this did not occur. (If T°inwas greater than T°out, the difference was positive; if T°outwas greater than T°in, the difference was negative). The aim was an end-tidal sevoflurane concentration of 2.1%, a target used in a previous study. Technically, we could not measure the sevoflurane concentrations at the inlet and outlet of the absorbent canister, so, for the time being, we can only speculate on the exact reasons. The reason for this difference is not clear, but such a reaction has also been observed by other authors. Calibration curves were linear over a range of 0.3–75 parts per million (ppm; vol/vol). In contrast, Cunningham et al. 1However, different carbon dioxide absorbents vary enormously in their capacity to produce compound A. In the ensuing chromatographic separation stage the use of a thick-film capillary column (CP-select 624, a 6% cyanopropylphenyl-dimethylsilicone stationary phase (Chrompack, Middelburg, The Netherlands) allowed adequate retention and isothermal separation at 38°C. After initial preparation and equilibration, liquid sevoflurane was injected with a syringe pump (Model 3500; Graseby, Watford, United Kingdom) into a small copper reservoir included in the breathing circuit. The median (range, minimum and maximum) values for lithium hydroxide and Sodasorb are shown. Chemical Composition of the Carbon Dioxide Absorbents Examined. Only by eliminating both KOH and NaOH from the absorbent is no compound A produced; thus, we can comply with the message about “putting the brakes on anesthetic breakdown” of a recent editorial on that subject. Fig. 2KOH + CO2 ----> K2CO3 + H2O Increases in the weight of U-tube containing KOH gives the weight of CO2 produced and form the weight of the CO2 obtained , Anaesthesia 1996; 51: 622–26, Fang ZX, Kandel L, Laster MJ, Ionescu P, Eger EI II: Factors affecting production of compound A from the interaction of sevoflurane with Baralyme, Higuchi H, Adachi Y, Arimura S, Kanno M, Satoh T: Compound A concentrations during low-flow sevoflurane anesthesia correlate directly with the concentration of monovalent bases in carbon dioxide absorbents. A modified PhysioFlex apparatus (Dräger, Lübeck, Germany) was connected to an artificial test lung (inflow at the top of the bellow approximately/= 160 ml/min CO2; outflow at the Y piece of the lung model approximately/= 200 ml/min, simulating oxygen consumption). Anesth Analg 2000; 91: 220–4, Förster H, Behne M, Warnken UH, Asskali F, Dudziak R: Die Anwendung von Lithium-hydroxid als Kohlendioxid-adsorbens verhindert das Entstehen von Compound A während Sevofluran Anästhesie. Compared with Sofnolime, KOH-free Sodasorb contains a somewhat higher concentration of NaOH and also a small amount of KOH; both of these might be an element in the intermediate position of this absorbent for compound A generation. Search for other works by this author on: Mazze RI, Jamison RL: Low-flow (1 l/min) sevoflurane: Is it safe? 8Injection was fully automated in a technique based on headspace sampling (1 ml). 1-Iodo-2,2,2-trifluoroethane was chosen as an internal standard. For overall comparisons of the AUCs between the five groups, the Kruskal-Wallis test was applied, followed by Wilcoxon rank sum tests for multiple pairwise comparisons. During the preparation of the test-lung setup new carbon dioxide absorbent (800 ml) was always used.

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