PMID- 16451150
OWN - NLM
STAT- MEDLINE
DCOM- 20060516
LR  - 20061012
IS  - 0001-5172 (Print)
IS  - 0001-5172 (Linking)
VI  - 50
IP  - 1
DP  - 2006 Jan
TI  - An interchangeable Mapleson A-E breathing system is practical and cost effective.
PG  - 45-9
AB  - BACKGROUND: In locations where oxygen and anesthesia gas supplies are limited, 
      and where circle systems are not practical, means to reduce fresh gas flow during 
      maintenance of inhalational anesthesia are of potential value. We investigated 
      whether a common transport breathing apparatus could be modified to allow 
      interchange between Mapleson D (Map-D) and Mapleson A (Map A) configurations. 
      METHODS: A common Map-D transport system was converted to a Map-A system by 
      switching positions of the exhaust valve and the elbow connector where fresh gas 
      is delivered; these two breathing systems were compared in this study. The key 
      question was whether rebreathing of CO2 could be eliminated at a lower fresh gas 
      flow rate (FGF) with the Map-A design. A structured protocol was followed. 
      RESULTS: A mean decrease in FGF of 2.8 l/min was seen with the Map-A apparatus 
      when compared with the Map-D (P=0.003). With no significant differences in 
      physiologic or anesthetic variables, FGF/V(E) was significantly lower with the 
      Mapleson A configuration than with the Mapleson D system design (1.1 vs. 1.8; 
      P=0.007). The extent to which FGF could be lowered when switching between 
      Mapleson D and A systems correlated strongly with the patients' respiratory rate 
      while under anesthesia (r=0.45, P<0.01). CONCLUSIONS: Cost and resource savings 
      can be realized through the use of a breathing system modification that achieves 
      appropriate ventilation at lower fresh gas flows.
FAU - Robinson, M
AU  - Robinson M
AD  - Department of Anesthesia, Stanford University School of Medicine and Palo Alto 
      Veterans Affairs Health Care System, Palo Alto, CA 94304, USA.
FAU - Lighthall, G K
AU  - Lighthall GK
LA  - eng
PT  - Journal Article
PL  - England
TA  - Acta Anaesthesiol Scand
JT  - Acta anaesthesiologica Scandinavica
JID - 0370270
SB  - IM
CIN - Acta Anaesthesiol Scand. 2006 Jul;50(6):772-3. PMID: 17004333
MH  - Adult
MH  - Aged
MH  - Anesthesia, Inhalation/economics/*instrumentation
MH  - Costs and Cost Analysis
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Respiration
MH  - *Ventilators, Mechanical/economics
EDAT- 2006/02/03 09:00
MHDA- 2006/05/17 09:00
CRDT- 2006/02/03 09:00
PHST- 2006/02/03 09:00 [pubmed]
PHST- 2006/05/17 09:00 [medline]
PHST- 2006/02/03 09:00 [entrez]
AID - AAS848 [pii]
AID - 10.1111/j.1399-6576.2005.00848.x [doi]
PST - ppublish
SO  - Acta Anaesthesiol Scand. 2006 Jan;50(1):45-9. doi: 
      10.1111/j.1399-6576.2005.00848.x.