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Master Thesis

Rapidité d’obtention d’une fraction expirée cible en oxygène : comparaison de l’AINOC et de différents débits de gaz frais pour les quatre respirateurs Aisys®, Felix Ainoc®, Zeus® et Flow-­‐i®

Abstract : Introduction : The speed of administration agents inhaled by anaesthetic ventilators depends on the minute ventilation, the fresh gas flow (FGF) and their design. To compensate for the slowness of inhaled anaesthesia, technological advances have permitted the development of systems of anaesthetic inhaled by Target Controlled Inhalation (TCI) to be more efficient which permits the administering of these anaesthetics in a faster time, with less overdose and in an economical and ecological fashion. The aim of this study is to compare the time delay obtained from the fractional concentration of oxygen in expired gas (FeO2) targeted in the TCI mode versus different GFR from 4 ventilators equipped with the TCI system currently on the market. Methods : We conducted a prospective clinical study, which was randomised, from January to September 2014 grouping 95 ASA I-II patients before undergoing ENT, plastic or maxillofacial surgery. Courses for maintaining general anaesthetic in double TIVA (Intra Venous Anaesthesia at Target Concentration) were recorded for the time required to move from a FeO2 of 30 to 90% and from 90% to 30% in TCI mode and FGF at 6L / min and 12L / min in accordance with the 10 minute stabilisation stages between each step. The minute volume, number of adjustments to obtain target Fe02 as well as the oxygen consumption were also noted. The time delays for obtaining a FeO2, expressed in seconds (s), were represented as median [interquartile range]. Results : Twenty-six patients were included in the Aisys® group, 23 in the Felix® group, 23 in the Zeus® group and 23 Flow-i® group. The demographic characteristics and the ventilatory and hemodynamic parameters of the included patients were comparable. Three patients from the Aisys® group never reached the FeO2 target at 90% and were excluded. The time delays for obtaining an Fe02 of 30% to 90% were most rapid in TCI mode (145s [110-172]) versus FGF 6L/min (157s [131-196]) and versus FGF 12L/min (148s [118-182]) for the Aisys® (p < 0,05). The FGF mode of 12L/min was significantly the most rapid in the Felix® group (212s [165-254]) versus FGF 6L/min (290 s [244-332]) and TCI (303 s [259-336]) (p < 0,05) as well as for the Zeus® FGF 12L/min (111 s [85-140]) versus FGF 6L/min (225s [179-248]) and TCI (356s [320-420]) (p < 0,05). For the Flow-i®, the TCI modes (145s [110-188]) and FGF 12L/min (145s [117-187]) were significantly more efficient than the FGF 6L/min method (172s [142-194]) (p < 0,05). Conclusion : The time required to obtain an Fe02 target and the consumption vary according to the TCI modes of different ventilators. The FGF at 12L / min is in all cases of doubt and extreme emergencies the suitable rate for the four ventilators to reach the maximum oxygenation of the patient, in the faster possible manner.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01390567
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Submitted on : Wednesday, November 2, 2016 - 10:58:35 AM
Last modification on : Wednesday, August 23, 2017 - 4:33:59 PM
Long-term archiving on: : Friday, February 3, 2017 - 12:55:37 PM

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Jean-Claude Pauchard. Rapidité d’obtention d’une fraction expirée cible en oxygène : comparaison de l’AINOC et de différents débits de gaz frais pour les quatre respirateurs Aisys®, Felix Ainoc®, Zeus® et Flow-­‐i®. Médecine humaine et pathologie. 2016. ⟨dumas-01390567⟩

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