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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2018 January;84(1):25-32

DOI: 10.23736/S0375-9393.17.11770-0


lingua: Inglese

The impact of the anesthetic conserving device on occupational exposure to isoflurane among intensive care healthcare professionals

Jennifer HERZOG-NIESCERY 1 , Heike VOGELSANG 1, Philipp GUDE 1, Hans-Martin SEIPP 2, Horst BARTZ 2, Waldemar UHL 3, Thomas P. WEBER 1, Martin BELLGARDT 1

1 Department of Anesthesiology, Ruhr-University Bochum, St. Josef Hospital, Bochum, Germany; 2 Department of Life Science Engineering, University of Applied Sciences, Giessen, Germany; 3 Department of Surgery, Ruhr-University Bochum, St. Josef Hospital, Bochum, Germany


BACKGROUND: Use of anesthetic conserving devices (ACD) for inhalational isoflurane sedation in Intensive Care Units (ICU) has grown in recent years, and healthcare professionals are concerned about isoflurane pollution and exposure-related health risks. Real-time measurements to determine isoflurane exposure in ICU personnel during short-term patient care procedures and ACD handling have not yet been performed.
METHODS: Isoflurane concentrations in the breathing zones of ICU staff (25 cm around the nose and mouth) were measured, by photoacoustic gas monitoring, during daily practice including tracheal suctioning, oral hygiene, body care, and patient positioning. Isoflurane pollution was further determined during ACD replacement, syringe filling, and after isoflurane spillages.
RESULTS: The average mean isoflurane concentration 25 cm above patients’ tracheostoma was 0.3 ppm. Mean (cmean) and maximum (cmax) isoflurane exposure in personnel’s breathing zones during patient care ranged from 0.4 to 1.9 ppm and 0.7 to 6.6 ppm, respectively. Isoflurane exposure during ACD replacement was cmean 0.5 to 17.4 ppm and cmax 0.8 to 114.3 ppm. Isoflurane concentrations during ACD syringe filling ranged from 2.4 to 9.1 ppm. The maximum isoflurane concentrations after spillage were dose-dependent.
CONCLUSIONS: Use of ACDs and patient physical manipulation are accompanied by isoflurane pollution. Baseline concentrations did not exceed long-term exposure limits, but short-term limits were occasionally exceeded during patient care procedures and ACD handling. Spillages should be avoided, especially when air-conditioning and scavenging systems are unavailable.

KEY WORDS: Intensive Care Units - Administration, inhalation - Isoflurane - Occupational exposure - Gas scavengers

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Publication History

Issue published online: January 12, 2018
Article first published online: June 14, 2017
Manuscript accepted: June 13, 2017
Manuscript revised: June 7, 2017
Manuscript received: October 25, 2016

Per citare questo articolo

Herzog-Niescery J, Vogelsang H, Gude P, Seipp HM, Bartz H, Uhl W, et al. The impact of the anesthetic conserving device on occupational exposure to isoflurane among intensive care healthcare professionals. Minerva Anestesiol 2018;84:25-32. DOI: 10.23736/S0375-9393.17.11770-0

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