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    Anesthesia Machine Circuits

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    Didi Ok
    Anesthesia circuits can be classified based on the Mapleson system. The circle system allows for partial rebreathing of gases and maintains heat and humidity. It has many components including a fresh gas source, unidirectional valves, and a CO2 absorber. The Bain system is a modified Mapleson D circuit that is compact and improves humidification through partial rebreathing. Different types of circuits include open, semi-open, semi-closed, and closed systems.

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    Anesthesia Machine Circuits

    Uploaded by

    Didi Ok
    218 views41 pages
    Anesthesia circuits can be classified based on the Mapleson system. The circle system allows for partial rebreathing of gases and maintains heat and humidity. It has many components including a fresh gas source, unidirectional valves, and a CO2 absorber. The Bain system is a modified Mapleson D circuit that is compact and improves humidification through partial rebreathing. Different types of circuits include open, semi-open, semi-closed, and closed systems.

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    Anesthesia circuits can be classified based on the Mapleson system. The circle system allows for partial rebreathing of gases and maintains heat and humidity. It has many components including a fresh gas source, unidirectional valves, and a CO2 absorber. The Bain system is a modified Mapleson D circuit that is compact and improves humidification through partial rebreathing. Different types of circuits include open, semi-open, semi-closed, and closed systems.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    218 views41 pages

    Anesthesia Machine Circuits

    Uploaded by

    Didi Ok
    Anesthesia circuits can be classified based on the Mapleson system. The circle system allows for partial rebreathing of gases and maintains heat and humidity. It has many components including a fresh gas source, unidirectional valves, and a CO2 absorber. The Bain system is a modified Mapleson D circuit that is compact and improves humidification through partial rebreathing. Different types of circuits include open, semi-open, semi-closed, and closed systems.

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    © All Rights Reserved
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    of 41

    Anesthesia Machine

    Circuits

    Anesthesia Circuits
    Link machine to patient
    Eliminate carbon dioxide
    Mapleson classification
    Many circuits in use
    Modified Mapleson still in use
    Know the current applications of
    modified Mapleson circuits

    Types of Circuits
    Basic circle system
    Mapleson Classification

    Circle System
    Allows rebreathing of anesthetic
    gases
    lower FGF rates
    Less pollution

    Requires CO2 absorption


    Conserves heat and humidity

    Advantages of Circle System

    Highly efficient
    Minimal dead space
    Conserves heat and moisture
    Minimal pollution
    Disadvantage - many places to leak

    Components of the Circle


    System
    Fresh gas source
    Unidirectional valves
    Inspiratory & expiratory tubing
    Y-piece connector

    Circle System Components


    APL valve
    Reservoir bag
    CO2 absorber

    Rules for Circle System


    Unidirectional valve must be
    between patient & bag on both sides
    FGF cannot enter between patient &
    expiratory valve

    Rules for Circle System


    (Contd)
    APL cannot be located between
    patient & inspiratory valve

    Four Basic Circuits

    Open
    Semi-open
    Semi-closed
    Closed

    Open Systems
    Insufflation
    blow anesthetic gas over face
    no direct contact
    no rebreathing of gases
    ventilation cannot be controlled
    unknown amount delivered

    Open Systems
    Open drop anesthesia
    gauze covered wire mask
    anesthesia dripped
    inhaled air passes through gauze &
    picks up anesthetic

    Open Systems (Contd)


    Open drop anesthesia (contd)
    concentration varies
    re-breathing may occur
    environmental pollution

    Semi-open Systems
    Breathing system which entrains
    room air
    Self inflating resuscitator system

    Semi-closed System
    Gas enters from machine
    part leaves via scavenger

    Circle system
    Bain system

    Closed System
    Only enough gas enters to meet
    metabolic needs
    Scavenger is closed
    Closed circle system
    To-and-fro system

    Closed System Anesthesia


    Technique not commonly used
    APL is closed and only enough O2 is
    added to meet metabolic needs
    Anesthetic added based on square
    root of time
    Conserves anesthetic gas an
    eliminates pollution

    The Scavenger System


    Releases excess pressure from
    the system
    Prevents operating room pollution
    Gases leave through APL
    May put too much negative
    pressure on the system

    Open System
    No reservoir
    No rebreathing

    Semi-open System
    Has reservoir
    No rebreathing

    Semi-closed System
    Has reservoir
    partial rebreathing

    Closed System
    Has reservoir
    Complete rebreathing

    Mapleson Breathing Circuits


    Early pioneers developed their own
    delivery systems
    Mapleson classified types of
    breathing devices

    Mapleson Breathing Circuits


    (Contd)

    Mapleson circuits fall into which type


    of system?
    See Morgan p. 26, Table 3-1

    Mapleson A

    FGI near bag


    Breathing tubing
    Expiratory valve near mask
    Volume of breathing tube should be
    as great as the tidal volume

    Mapleson A
    Spontaneous ventilation
    High FGF flushes tubing between
    breaths

    Mapleson A (Contd)
    Using pop-off enables controlled
    ventilation but also causes CO2
    rebreathing
    Current use?

    Mapleson B
    Similar to A with FGI near expiratory
    valve
    System fills with FGF
    inhaled by patient

    Mapleson B (Contd)
    Exhaled gas forced out through
    expiratory valve
    Current use?

    Mapleson C
    Similar to Mapleson B
    Shorter breathing tubing
    less dead space

    Current use?

    Mapleson D
    Long breathing tube
    FGI near mask
    Exhalation valve at distal end of
    breathing tubing
    Current use?

    Bain Breathing Circuit


    Modified Mapleson D
    Tube within a tube
    FGF tube within larger tube

    Mounts on anesthesia machine


    APL valve
    Connects to scavenger

    Bain System
    Advantages
    compact, easy to handle
    warming of inspired gases
    partial rebreathing improves
    humidification
    APL controls system pressure
    ability of scavenging

    Bain System Flow Rates


    Spontaneous ventilation
    200-300 ml/kg/min

    Controlled ventilation
    infants <10kg
    10 - 50 kg
    > 60 kg

    2 l/m
    3.5 l/m
    70 ml/kg/min

    Bain System
    Depends on fresh gas flow to flush
    out CO2
    Spontaneous ventilation
    200 - 300 ml / kg / min

    Controlled ventilation
    70 ml / kg / min

    Mapleson E
    Exhalation tube is reservoir
    no bag

    FGI near mask


    Current use?

    Mapleson F

    FGI near mask


    Breathing tubing/bag
    Expiratory valve at end of bag
    Current use?

    CO2 Absorption
    Soda lime
    94% calcium hydroxide
    5% sodium hydroxide
    1% potassium hydroxide
    silica to harden granules
    ethyl violet as an indicator

    CO2 Absorption
    Baralime
    80% calcium hydroxide
    20% barium hydroxide
    ethyl violet as an indicator

    CO2 Absorption
    pH is extremely high
    Granule size
    4 8 mesh

    Water is required for chemical


    reactions to occur

    CO2 Absorber
    Incompatibility
    Trichlorethylene
    dichloroacetylene
    neurotoxin

    Phosgene
    pulmonary irritant

    Sevoflurane
    degrades in absorber

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