Biomaterial Database

Carbon monoxide generation in carbon dioxide absorbents. 1995

J Baum, and G Sachs, and C vd Driesch, and H G Stanke

Abteilung für Anästhesie und Intensivmedizin, Krankenhaus St. Elisabeth-Stift, Damme, Germany.

Several cases of unexpected high carboxyhemoglobin (COHb) levels in patients undergoing general anesthesia were observed. To avoid carbon monoxide (CO) intoxication, the use of high fresh gas flows and frequent changes of the absorbent were recommended. However, due to economic and ecologic considerations, low-flow anesthetic techniques have advantages. Thus, the subject urgently needed to be reexamined. In 1001 patients undergoing enflurane or isoflurane anesthesia, blood samples were taken 30 min after fresh gas flow reduction to 0.5 L/min and analyzed for COHb. The absorbent canisters, containing soda lime, were used for several days. The statistical mean and SD of COHb was 1.17% +/- 0.97% in the range of 0%-7.6%. There was no statistical difference between the COHb values when broken down by the duration of use of the absorbent canisters. In no case were dangerously high COHb levels observed. As recently revealed, only dry absorbents produce CO if exposed to volatile anesthetics containing a CHF2-moiety. Thus, all measures must be avoided that dry out the absorbent. Low-flow anesthesia preserves the moisture content of the absorbent and, thus, seems to be a factor protecting from CO generation.

UI	MeSH Term	Description	Entries
D007530	Isoflurane	A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
D010087	Oxides	Binary compounds of oxygen containing the anion O(2-). The anion combines with metals to form alkaline oxides and non-metals to form acidic oxides.	Oxide
D002245	Carbon Dioxide	A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals.	Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D002248	Carbon Monoxide	Carbon monoxide (CO). A poisonous colorless, odorless, tasteless gas. It combines with hemoglobin to form carboxyhemoglobin, which has no oxygen carrying capacity. The resultant oxygen deprivation causes headache, dizziness, decreased pulse and respiratory rates, unconsciousness, and death. (From Merck Index, 11th ed)	Monoxide, Carbon
D002263	Carboxyhemoglobin		Carbomonoxyhemoglobin,Carbonmonoxyhemoglobin,Carbonylhemoglobin,Carboxyhemoglobin A,Carboxyhemoglobin C
D004737	Enflurane	An extremely stable inhalation anesthetic that allows rapid adjustments of anesthesia depth with little change in pulse or respiratory rate.	Alyrane,Enfran,Enlirane,Ethrane,Etran
D004867	Equipment Design	Methods and patterns of fabricating machines and related hardware.	Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D004869	Equipment Safety	Freedom of equipment from actual or potential hazards.	Device Safety,Hazards, Equipment,Medical Device Safety,Safety, Equipment,Device Safety, Medical,Safety, Medical Device,Equipment Hazard,Equipment Hazards,Hazard, Equipment,Safety, Device
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000327	Adsorption	The adhesion of gases, liquids, or dissolved solids onto a surface. It includes adsorptive phenomena of bacteria and viruses onto surfaces as well. ABSORPTION into the substance may follow but not necessarily.	Adsorptions