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KMID : 0352120160310010015
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Journal of Kyung Hee University
2016 Volume.31 No. 1 p.15 ~ p.21
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Effects of Fresh Gas Flow, Respiratory Rate, and Mode of Ventilation on Recovery of Tidal Volume after Circuit Disconnection
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Kang Yoo-Jin
Jeong Dae-Hee
Cha Jung-Eun
Choi Jeong-Hyun
Choi Young-Kyoo
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Abstract
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Purpose: The aim of this study was to determine the optimal fresh gas flow (FGF) and respiratory rate (RR) for rapid recovery of the tidal volume (TV) after breathing circuit disconnection.
Methods: We collected data using two anesthesia machines with either an ascending bellow-type ventilatoror piston-type ventilator. The primary measured parameters were the TV recovery time (sec) according to change in FGF from 1 to 15 L/min in order to determine the optimal FGF. For the secondary results, at the optimal FGF, we measured the TV recovery times (sec) according to change in RR from 8 to 20 breaths/min to determine the optimal RR.
Results: In the piston-type ventilator, the recovery time to a TV of 450 ml was about 43.0±0.7sec regardless of changes in FGF from 1 to 15L/min with an RR of 10breaths/min and was decreased until achieving an RR of 20 breaths/min (18.3±1.3 sec). In the ascending bellow-type ventilator, the TV recovery time with an FGF of 8 L/min was 43.6±1.2sec and was the shortest at RR of 15 breaths/min (26.1±1.7 sec).
Conclusions: In order to reduce the TV recovery time after reconnection of an accidentally disconnected circuit, we recommend increasing the FGF to 8 L/min, increasing the RR to 15 breaths/min, especially in the ascending bellow-type ventilator. More vigilance for circuit disconnection is needed when the ascending bellow-type ventilator with low-flow anesthesia and PEEP is used in patients who are vulnerable to desaturation.
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KEYWORD
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Breathing circuit, Disconnection, Fresh gas flow, Tidal volume, Respiratory rate
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