title: Carboxyhemoglobin concentrations during desflurane and isoflurane closed-circuit anesthesia.
abstract: Desflurane has been implicated in carbon monoxide (CO) intoxication during general anesthesia under certain circumstances. Carboxyhemoglobin (COHb) concentrations were determined in forty-one patients who were randomly allocated to receive closed-circuit anesthesia (CCA) with 1.3 MAC of desflurane (n = 21) or isoflurane (n = 20) in oxygen. Soda lime was used to bind the produced CO2 in previous anesthetic procedures with fresh gas flows of < 21/min. In the desflurane group, COHb concentrations (mean +/- SD) were 0.86 +/- 1.15% and 0.81 +/- 1.11% before and after 1 h of anesthesia, respectively. In the isoflurane group, COHb concentrations were 1.15 +/- 1.47% and 1.19 +/- 1.39% before and after 1 h of anesthesia, respectively. COHb concentrations did not increase after 2 h of CCA in seven patients. Our data suggest that closed-circuit anesthesia with desflurane or isoflurane does not produce clinically significant increases in COHb concentrations under conditions that allow the soda lime to remain sufficiently wet.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine, Pennsylvania, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Hendrickx
authors.forename: M
authors.initials: M
authors.lastname: Soetens
authors.forename: M
authors.initials: M
authors.lastname: De Vel
authors.forename: P
authors.initials: P
authors.lastname: Van der Aa
authors.forename: A M
authors.initials: AM
authors.lastname: De Wolf
mesh_terms: D000328:Adult; D000764:Anesthesia, Closed-Circuit / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000378:metabolism*; D002263:Carboxyhemoglobin / Q000032:analysis*; D000077335:Desflurane; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged
chemical_list: D018685:Anesthetics, Inhalation; D006454:Hemoglobins; D002263:Carboxyhemoglobin; D000077335:Desflurane; D007530:Isoflurane