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Inadequate gas supply to patients with an adjustable pressure-limiting valve in the fully opened position

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Abstract

With spontaneous ventilation, sufficient exhaust resistance at the adjustable pressure-limiting (APL) valve when fully opened ensures that the reservoir bag fills and adequately supplies gas to patients. A lack of exhaust resistance with the APL valve fully open caused inadequate gas supply to patients with four types of anesthesia machines: SA2 (Dräger), Excel-210 SE (GE), Fabius (Dräger), and Cato (Dräger). Mechanically, the SA2 and Excel-210 SE APL valve systems, which are of the spring-loaded disc type positioned horizontally, cannot maintain sufficient exhaust resistance with the APL valve fully open. As for the Fabius and Cato, an exhaust valve independent of the APL valve should maintain sufficient exhaust resistance continuously. However, accumulated viscous substances on the thin diaphragm of the exhaust valve contributed to hindrance of diaphragm closure.

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References

  1. Inhalational anesthesia systems-Part 2: anesthetic breathing systems for adults. ISO 8835-2. 1993.

  2. Recommendations for pre-anesthesia checkout procedures. Sub-committee of ASA Committee on Equipment and Facilities. 2008.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Hachioji Medical Center, Tokyo Medical University, 1163 Tatemachi, Hachioji, Tokyo, 193-0998, Japan

    Go Hirabayashi & Yukihiko Ogihara

  2. Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Hiroyuki Uchino

  3. Department of Anesthesia, Kosei Chuo General Hospital, 1-11-7 Mita, Meguro-ku, Tokyo, 153-8581, Japan

    Akibumi Omi

  4. Department of Anesthesiology, Teikyo University School of Medicine, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki, Kanagawa, 213-8507, Japan

    Akito Ohmura

Authors
  1. Go Hirabayashi
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  2. Hiroyuki Uchino
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  3. Yukihiko Ogihara
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  4. Akibumi Omi
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  5. Akito Ohmura
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Corresponding author

Correspondence to Go Hirabayashi.

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Hirabayashi, G., Uchino, H., Ogihara, Y. et al. Inadequate gas supply to patients with an adjustable pressure-limiting valve in the fully opened position. J Anesth 24, 626–629 (2010). https://doi.org/10.1007/s00540-010-0958-6

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  • DOI: https://doi.org/10.1007/s00540-010-0958-6

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