Journal of Isfahan Medical School

Journal of Isfahan Medical School

Comparative Evaluation of Cost and Benefit of Two High and Low End-Inspiratory Carbon Dioxide Pulmonary Mechanical Ventilation during General Anesthesia

Document Type : Original Article (s)

Authors
Mojtaba Mansouri 1
Hengameh Molavi 2
Faezeh Farhang-Kouhpaei 2
1 Associate Professor, Anesthesiology and Critical Care Research Center AND Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: During pulmonary mechanical ventilation in general anesthesia, end tidal carbon dioxide concentration should be preserved in the range of 0-1 mmHg. It seems that pulmonary ventilation with high end-inspiratory carbon dioxide concentration prevents loss of fresh inspiratory gases and inhalation anesthetic drugs and is affordable. This study was designed to evaluate the cost and benefit of two different anesthesia methods, high and low end-inspiratory carbon dioxide concentration.Methods: In this prospective, randomized and single-blind clinical trial, patients were studied in two groups of 34. Patients were ventilated with high and low end-inspiratory carbon dioxide concentrations in study and blank groups. Objectives were end- inspiratory and expiratory carbon dioxide concentration, amount of fresh inspiratory gas, and isoflurane and soda lime consumption and their costs.Findings: The amount of fresh inspiratory gas consumption and its costs over the duration of surgery was significantly lower in the test group (P < 0.001). The amount and cost of consumed isoflurane during surgery was significantly lower in the test group, too (P < 0.001)Conclusion: In general anesthesia, pulmonary mechanical ventilation with high end-inspiratory carbon dioxide concentration lead to lower consumption of fresh inspiratory gases, inhaled anesthetics and soda lime. Ultimately, lower costs are imposed to patients and healthcare system.
Keywords
End inspiratory carbon dioxide
End expiratory carbon dioxide
Fresh gas flow
Low flow anesthesia
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Journal of Isfahan Medical School
Volume 32, Issue 299 - Serial Number 299
July and August 2014
Pages 1379-1387

  • Receive Date 22 September 2013
  • Accept Date 06 April 2022