Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessment

# Introduction The use of volatile anesthetic agents in the paediatric intensive care unit (PICU) is experiencing increased interest since the availability of the miniature vapourizing device. However, the effectiveness of scavenging systems in the presence of humidifiers in the ventilator circuit...

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Main Authors: Katherine Reise, Jason Macartney, Richard La, Angela Jerath, Marat Slessarev, Brian H. Cuthbertson, Saptharishi Lalgudi Ganesan, Nicole K. McKinnon
Format: Article
Language:English
Published: Canadian Society of Respiratory Therapists 2024-06-01
Series:Canadian Journal of Respiratory Therapy
Online Access:https://doi.org/10.29390/001c.118513
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author Katherine Reise
Jason Macartney
Richard La
Angela Jerath
Marat Slessarev
Brian H. Cuthbertson
Saptharishi Lalgudi Ganesan
Nicole K. McKinnon
author_facet Katherine Reise
Jason Macartney
Richard La
Angela Jerath
Marat Slessarev
Brian H. Cuthbertson
Saptharishi Lalgudi Ganesan
Nicole K. McKinnon
author_sort Katherine Reise
collection DOAJ
description # Introduction The use of volatile anesthetic agents in the paediatric intensive care unit (PICU) is experiencing increased interest since the availability of the miniature vapourizing device. However, the effectiveness of scavenging systems in the presence of humidifiers in the ventilator circuit is unknown. # Approach (Methods) We performed a bench study to evaluate the effectiveness of the Deltasorb® scavenging system in the presence of isoflurane and active humidity by simulating both infant and child ventilator test settings. A total of four ventilators were set to ventilate test lungs, all with active humidity and a Deltasorb scavenging canister collecting exhaled ventilation gas. Two ventilators also had isoflurane delivered using the Anesthesia Conserving Device- small (ACD®-S) on the inspiratory limb (also called alternative ventilator configuration). We performed instantaneous measurements of isoflurane and continuous sampling with passive badges to measure average environmental exposure over a test period of 6.5 hours. Scavenging canisters were returned to the company, where desorption analysis showed the volume of water and isoflurane captured in each canister. # Findings Both instantaneous point sampling and diffusive sampling results were below the occupational exposure limit confirming safety. The canisters collected both isoflurane and a portion of the water vapour delivered; the percentage of captured water and isoflurane collected in infants was higher than the child ventilator test settings. # Practice implications (Conclusion) The tested scavenging configuration was effective in maintaining a safe working environment with active humidity and inspiratory limb (alternative) ventilator configuration of the the miniature vapourizing device.
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spelling doaj-art-e3fb2b527ea346a8b934f5708f1805272025-02-11T20:30:53ZengCanadian Society of Respiratory TherapistsCanadian Journal of Respiratory Therapy2368-68202024-06-0160Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessmentKatherine ReiseJason MacartneyRichard LaAngela JerathMarat SlessarevBrian H. CuthbertsonSaptharishi Lalgudi GanesanNicole K. McKinnon# Introduction The use of volatile anesthetic agents in the paediatric intensive care unit (PICU) is experiencing increased interest since the availability of the miniature vapourizing device. However, the effectiveness of scavenging systems in the presence of humidifiers in the ventilator circuit is unknown. # Approach (Methods) We performed a bench study to evaluate the effectiveness of the Deltasorb® scavenging system in the presence of isoflurane and active humidity by simulating both infant and child ventilator test settings. A total of four ventilators were set to ventilate test lungs, all with active humidity and a Deltasorb scavenging canister collecting exhaled ventilation gas. Two ventilators also had isoflurane delivered using the Anesthesia Conserving Device- small (ACD®-S) on the inspiratory limb (also called alternative ventilator configuration). We performed instantaneous measurements of isoflurane and continuous sampling with passive badges to measure average environmental exposure over a test period of 6.5 hours. Scavenging canisters were returned to the company, where desorption analysis showed the volume of water and isoflurane captured in each canister. # Findings Both instantaneous point sampling and diffusive sampling results were below the occupational exposure limit confirming safety. The canisters collected both isoflurane and a portion of the water vapour delivered; the percentage of captured water and isoflurane collected in infants was higher than the child ventilator test settings. # Practice implications (Conclusion) The tested scavenging configuration was effective in maintaining a safe working environment with active humidity and inspiratory limb (alternative) ventilator configuration of the the miniature vapourizing device.https://doi.org/10.29390/001c.118513
spellingShingle Katherine Reise
Jason Macartney
Richard La
Angela Jerath
Marat Slessarev
Brian H. Cuthbertson
Saptharishi Lalgudi Ganesan
Nicole K. McKinnon
Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessment
Canadian Journal of Respiratory Therapy
title Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessment
title_full Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessment
title_fullStr Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessment
title_full_unstemmed Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessment
title_short Volatile gas scavenging in the paediatric intensive care unit: Occupational health and safety assessment
title_sort volatile gas scavenging in the paediatric intensive care unit occupational health and safety assessment
url https://doi.org/10.29390/001c.118513
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