Currently, two devices are commercially available, AnaConDa™ (Sedana Medical, Uppsala, Sweden), and M irus™ (Pall Medical, Dreieich, Germany). Inhalation sedation has been implemented as an alternative sedation regimen in the Spanish, British, and German sedation guidelines.
Under BTPS conditions and with the use of moderate inhaled agent concentrations, reflective dead space is small and similar between the two devices.Īnaesthetic reflectors are increasingly used in intensive care units to sedate critically ill patients. In addition to volumetric dead space, reflective dead space was determined as 198 ± 6/58 ± 6/35 ± 0/25 ± 0 ml under ATP/BTPS/ISO-0.4/ISO-1.2 conditions for AnaConDa, and 92 ± 6/25 ± 0/25 ± 0/25 ± 0 ml under the same conditions for M irus, respectively. Isoflurane further decreased insp-CO 2 and abolished the difference between AnaConDa and M irus. Insp-CO 2 was higher with AnaConDa compared to M irus and higher under ATP compared to BTPS. Tidal volume increase to maintain normocapnia was also determined. Inspired (insp-CO 2) and end-tidal carbon dioxide concentrations (et-CO 2) were measured under four conditions: ambient temperature pressure (ATP), body temperature pressure saturated (BTPS), BTPS with 0.4 Vol% (ISO-0.4), and 1.2 Vol% isoflurane (ISO-1.2). HME, M irus and AnaConDa were connected successively. A constant flow of carbon dioxide was insufflated into the test lung, ventilated with 500 ml, 10 breaths per minute. Therefore, we compared carbon dioxide elimination of both with a heat moisture exchanger (HME, 35 ml) in a test lung model. However, their internal volume (100 ml) and possible carbon dioxide reflection raised concerns. For this purpose, two anaesthetic reflectors, AnaConDa™ and Mirus™ are commercially available. Inhalation sedation is increasingly performed in intensive care units.
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