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Total ventilation formula dead space2/1/2024 ![]() Baltimore, MD, USA: Williams & Wilkins 1981. The quantitative practice of anesthesia: use of closed circuit. Performance with other agents and N 2O awaits further validation. F VAP can be retrospectively calculated from F IN, F ET, FGF, and MV plus an agent specific dead space fraction factor with a degree of error that we believe suffices for retrospective sevoflurane consumption analyses. The model predicted dialed F VAP well, with a MDPE of −1 (−11, 6) % and MDAPE of 8 (4, 17) %. ![]() For prospective testing, a total of 149.4 h of useful data were collected from 78 patient with the Zeus and Flow-i combined, with FGF ranging from 0.18 to 8 L/min. ![]() The empirical dead space fraction for isoflurane, sevoflurane, and desflurane were 0.59, 0.49, and 0.66, respectively. ![]() MDPE and MDAP are reported as median and interquartiles. Because both workstations use an electronically controlled vaporizer/injector, the dialed F VAP were available to allow the calculation of median performance error (MDPE) and median absolute performance error (MDAPE). With dead space fraction known, the model was then prospectively tested for sevoflurane in O 2/air using data collected over the course of two weeks with one FLOW-i (Getinge, Solna, Sweden) and one Zeus workstation (Dräger, Lübeck, Germany). Dead space fraction for each agent was determined empirically by having Excel’s solver function calculate the value of dead space fraction that minimized the sum of the squared differences between dialed F VAP and predicted F VAP. Dead space fraction for sevoflurane, desflurane, and isoflurane was therefore determined empirically from an unpublished data set of 161 patient containing F VAP, F IN, F ET, MV and FGF ranging from 0.25 to 8 L/min delivered via an ADU® (GE, Madison, WI, USA). F IN, F ET, FGF and MV are routinely monitored, but dead space fraction is unknown. Theoretical analysis of agent mass balances in the circle breathing reveals F VAP = /(1-(1 − FGF/MV)). ![]() The current study examines how F VAP can be retrospectively calculated from the agent’s inspired (F IN) and end-expired concentration (F ET), FGF, and minute ventilation (MV). Because F VAP of conventional vaporizers is not registered in automated anesthesia records, retrospective agent consumption studies are hampered. Anesthetic agent consumption is often calculated as the product of fresh gas flow (FGF) and vaporizer dial setting (F VAP). ![]() AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |