NT TNT coin Vetamac Vapors Vol. IX + Issue 4 + Winter 2013 How Many O's Are Enough? (One of the primary functions ofan anesthetic machine isto delver oxygen. This ssue of Vapors wil discuss why oxygen flow is needed andhow much low srequired Oxygen provided, first ofall sustain theif ofthe patient during the cours ofa procedure. The anesthetic machine has aflowmeter that delivers low in ms/minuteor iters/minute. Two typesofsystems are commonly used to deliver gato the patient: 1) arebreathingsystem and 2) a non-rebreathing system. In a rebreathing sytem, a portion of the oxygen delivered is rebreathed bythe patient. This rebreathing of a portion ofthe expied goss possible because the system has uni-directional or one-way valves and provides forthe removal of expired CO. Ths prevents the rebreathing of 0, (and anesthetic) before the CO, is removed. itis possible (but not likely) that one specific atom of oxygen introduced during induction could remain in the system for the duration ofthe procedure. However, when a non rebreathng system is used propery there iso rebreathing of any af the expired gas, therefore the oxygen flow must be sufficient to move the expired gas avay from the [Link] the non-rebreathingsjstem requitesahigherflow than the rebreathing system. ‘The question of oxygen purity should be briefly discussed since oxygen concentrators and generators are being more widely used. Is 100% oxygen necessary fr patient survival? The answer sno. Eventhough it isnot recommended clinically there are research applications that use room airforanestheticprocedures. Most rygen concentrators produce 90-95% oxygen. Ithe concentration drops to 80-85%, this isprobably ofltteorno consequence tothe patient but rather indicatesafalure of the concentrator. When performing inhalation anesthesia, oxygen is required for a second reason: it is the carrier gas for the anesthetic vapor. (The only. exception to thsis when the vaporize isin the circle and this will not be discussed.) There must be gas low through the vaporizer to pickup and carty the vaporized anesthetic tothe breathing sytem. This flow doesnot affect the concentration of anesthetic but does affect the quantity of liquid agent consumed. At 1 lter/minute flow and a 25 setting on the vaporizer, 6 mls of iquid will be consumed per hour. Ifthe flow is 2 liters/minute, the consumption will be 12 mls/hour. (Visit our website, [Link] and follow the link for “Knowledge” to find a consumption chart for both isoflurane and sevoflurane). The question now is how much flow is required? The fist issue to address isthe metabolic requirement of the patient which is approximately 1mi/lb/min, Witha SOlb. dog, the amount a axygen removed fram the system would be 50 mis/min Itisevdent that the flows commonly introduced into thecircuitarein excess of what the patient requires. Thisralses ‘the question of why excessive flow is used, One reason is that there may be leaks in the anesthetic sytem or the Ke [ = MIM) evacuation system may not be functioning properly allowing gas to escape from the system necessitating increased co flow. Another reason stat itis easy to pre-determinea set flow and use that as a standard flow forall procedures riflb/min, that isa sufficient flow for a 100 Ib. patient. Therefore, any flow above 500 mis/min would be sufficient for any animal 100 Ibs. or less. It seems that most practices use a Lliter/minute flow forall patients. There are some ‘that use ahigher low and some alower flow according totheir preference. As stated above, a non-rebreathing system requires a higher flow rate because the flow of fresh gas is what ‘moves the expired gas away from the patient. Itis fecommended that 2 minimum flow of 1.5 liters/min be used with a non-rebreathing system. The flow should be 2.0-2.5 lters/min for patients above 15 Ibs. Ifyour practice requiresa calculated flow rate, see the chart in Anesthesia for Veterinary Technicians edited by Susan Bryant, page 84. rr This minimizes the chance for errors that might occur when calculating a flow. Finally, concentration calibrated CACTI SI | (cirect read) vaporizers require a minimum flow for the output to remain constant. Ifthe flow is below 500 cc/min, Technicians ‘the output will tend to be lower than the dial setting, There must be enough flow to overcome the resistance created PASE | inthe vaporizersothata portion ofthe flow is diverted into the vaporization chamber. ame What ongen low shuld be sed? the vaporizer requires S00 ml/min low, andi the patent consumes ‘One final reminder, flow rate determines the amount of liquid anesthetic agent consumed. By Harry Latshaw_ IMS, RVT, VTS (Anesthesia) We need your help! Please verify that you have our correct mailing address for all correspondence or payments: PO Box 178 Rossville, Indiana 46065 ‘The US Postal Service is returning a lot of our mail due to either an incorrect address or having our street included with the PO number. ‘Any UPS or FedEx ground shipments should be addressed to 130 Roth Court, Rossville, IN 46065. Thank you! PA Tua) Te nestnctic GEC ecky ea Ett) ne een ee edProduct of the Quarter Anti-Spill Adapters + The anti-spill adapter allows the filling ofa funnel-fill vaporizer without excessive spillage and prevents environmental contamination. + Reusable + Can be left on bottle and recapped. #911111 Isoflurane (Purple) #911113 Sevoflurane (Yellow) Sale Price $28.50 Pree Good Thr 0331/2044 Find us Ei Follow us © Visit our Web Store for easy online ordering! [Link] GaLSANdDay JDIANAS SSANaGV S909b NI ‘AI[lAsSo BLI X09 Od OO} Aung ‘Noy YOY Os! ICPULLIA Please visit our booth at these upcoming Veterinary Shows January 24-25, 2014 Michigan Veterinary Conference Lansing Center, Hall A Booth 35 Lansing, MI January 30-February 1, 2014 130th Indiana Veterinary Medical "Association Annual Meeting Marriott East Hotel, Booth 18 Indianapolis, IN NOSED Ee maui ey ce arc) DASE mL) February 12-13, 2014 Veterinary Medical Association ter Conference jeman Building ‘Ames, 1A ‘ebruary 20-22, 2014 st Veterinary Conference 3 Columbus\Gonvention Center, 7 826 Bet bus, OH os 1-800-334-1583