Low Flows Revisited

Ab, Baker

doi:10.1177/0310057x0903700623

Cited by 1 publication

(1 citation statement)

References 30 publications

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“…Reasons for not using minimum flows of 0.5 l/minute included concerns among some anaesthetists about the regulatory guidelines in Australia that recommend flow rates not less than 2 l/minute when using sevoflurane because of its potential renal toxic by-product Compound A 22,23 . A recent editorial by Feldman, however, questions these limitations 2 , with countries such as New Zealand, the United Kingdom, Japan and most of Europe having no recommendations on minimum fresh gas flow rates 24 . Surprisingly, the cost of CO 2 absorbents (Medisorb) did not rise.…”

Section: Manualmentioning

confidence: 99%

Financial and Environmental Costs of Manual versus Automated Control of End-Tidal Gas Concentrations

Tay

Weinberg

Peyton

et al. 2013

Anaesth Intensive Care

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Emerging technologies that reduce the economic and environmental costs of anaesthesia have had limited assessment. We hypothesised that automated control of end-tidal gases, a new feature in anaesthesia machines, will consistently reduce volatile agent consumption cost and greenhouse gas emissions. As part of the planned replacement of anaesthesia machines in a tertiary hospital, we performed a prospective before and after study comparing the cost and greenhouse gas emissions of isoflurane, sevoflurane and desflurane when using manual versus automated control of end-tidal gases. We analysed 3675 general anaesthesia cases with inhalational agents: 1865 using manual control and 1810 using automated control. Volatile agent cost was $18.87/hour using manual control and $13.82/hour using automated control: mean decrease $5.05/hour (95% confidence interval: $0.88-9.22/hour, P=0.0243). The 100-year global warming potential decreased from 23.2 kg/hour of carbon dioxide equivalents to 13.0 kg/hour: mean decrease 10.2 kg/hour (95% confidence interval: 2.7-17.7 kg/hour, P=0.0179). Automated control reduced costs by 27%. Greenhouse gas emissions decreased by 44%, a greater than expected decrease facilitated by a proportional reduction in desflurane use. Automated control of end-tidal gases increases participation in low-flow anaesthesia with economic and environmental benefits.

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Section: Manualmentioning

confidence: 99%