Key findings from 2010 study on CO2 absorbent surprisingly ignored!
Richard J. Levy, MD,* Viviane G. Nasr, MD,* Ozzie Rivera, BS,† Renee Roberts, MD,* Michael Slack, MD,‡ Joshua P. Kanter, MD,‡ Kanishka Ratnayaka, MD,‡ Richard F. Kaplan, MD,*and Francis X. McGowan, Jr., MD§ (Anesth Analg 2010;110:747–53)
Excerpts and quotes from the study:
Carbon Monoxide was detected routinely during general anesthesia in infants and children when using fresh GE Medisorb, a soda lime. (It has long been known that CO is produced in desiccated soda lime yet surprising to be found when using fresh soda lime.)
Carbon Monoxide is a known neurotoxin. Exposure to low concentrations of CO (12.5ppm) can cause neurotoxicity in the developing brain and may lead to neuro developmental impairment. Peak CO levels measured in the anesthesia breathing circuit were in the range thought to impair the developing brain.
The study suggests that use of carbon dioxide adsorbents that lack strong metal hydroxide (ie. the Amsorb Plus CO2 absorbent) could limit inspired CO if detection was attributed to degradation of volatile anesthetic. …findings suggest the use of carbon dioxide absorbents that lack strong metal hydroxide (the Amsorb Plus CO2 absorbent does not use strong metal hydroxides).
Young children exposed to inhaled anesthetics were twice as likely to develop behavioral or developmental disorders after exposure.
The study measured CO levels in the circuit and in the blood stream via COHb.
CO binds 240 times more avidly to hemoglobin than oxygen.
The APSF recommends using adsorbents that do not use strong metal hydroxides(sodium hydroxide), (the Amsorb Plus CO2 absorbent does not use strong metal hydroxides or sodium hydroxide).
The APSF recommended not using absorbents based on strong alkali or metal hydroxides. The Amsorb Plus CO2 absorbent does not contain strong alkali or metal hydroxides and is thus recommended by the APSF.
For more information on Amsorb Plus CO2 absorbent contact Bell Medical at 314-772-5600.