title: Comparison of minimal fresh gas requirements of baby enclosed afferent reservoir and Jackson Rees anesthetic circuit for general anesthesia in spontaneously breathing children.
abstract: OBJECTIVE
  The authors compared the baby enclosed afferent reservoir (Baby EAR) with the Jackson-Rees (JR) anesthesia circuit for the minimal fresh gas flow (FGF) requirement with no and clinically acceptable rebreathing in spontaneous breathing anesthesia among pediatric patients.
  
  
  METHODS
  The present study was a randomized crossover study. Twenty patients, weighing 5 to 20 kg with ASA physical status I-II were enrolled. They were allocated to group 1 (EAR-JR) starting with Baby EAR then switching to JR or group 2 (JR-EAR), reversedpattern. After induction and intubation, anesthesia was maintainedwith a N2O/O2 combination with sevoflurane 1 to 3% and fentanyl. Starting with the first circuit, all patients were spontaneously ventilated with FGF 500 mL/kg/min for 10 minutes, and then gradually decreased by 50 mL/kg/min every five minutes. End-tidal CO2 (ETCO) and inspired minimum CO2 (imCO) were recorded until rebreathing (imCO2 >2 mmHg) occurred and continued until rebreathing was not clinically acceptable (imCO2 >6 mmHg). The anesthesia breathing circuit was switched and the procedure repeated.
  
  
  RESULTS
  The minimal FGF at no rebreathing of Baby EAR and JR were 192.5±76.6 and 347.5±108.2 mL/kg/min; p<0.001. At acceptable rebreathing, the values were 117.5±46.7 and 227.6±90.6 mL/kg/min; p< 0. 001.
  
  
  CONCLUSIONS
  Baby EAR can be used safely, effectively, and requires less FGF than JR in pediatric anesthesia in patients weighing 5 to 20 kg.
authors: Sunchai
authors: S
authors: Theerapongpakdee
authors: Thepakorn
authors: T
authors: Sathitkamrnmanee
authors: Sirirat
authors: S
authors: Tribuddharat
authors: Nonthida
authors: N
authors: Rojanapithayakorn
authors: Kanchana
authors: K
authors: Uppan
authors: Cattleya
authors: C
authors: Thongrong
authors: Piyaporn
authors: P
authors: Bunsangcharoen
mesh_terms: D000293:Adolescent; D000764:Anesthesia, Closed-Circuit / Q000295:instrumentation* / Q000379:methods*; D001835:Body Weight; D002245:Carbon Dioxide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D009609:Nitrous Oxide / Q000008:administration & dosage; D010100:Oxygen / Q000008:administration & dosage; D010372:Pediatrics / Q000295:instrumentation* / Q000379:methods*; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods*; D000077149:Sevoflurane; D013785:Thailand
chemical_list: D008738:Methyl Ethers; D002245:Carbon Dioxide; D000077149:Sevoflurane; D009609:Nitrous Oxide; D010100:Oxygen