{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:42:44Z","timestamp":1786981364259,"version":"build-2736575974"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Clin Monit Comput"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As volatile anaesthetic gases contribute to global warming, improving the efficiency of their delivery can reduce their environmental impact. This can be achieved by rebreathing from a circle system, but also by anaesthetic reflection with an open intensive care ventilator. We investigated whether the efficiency of such a reflection system could be increased by warming the reflector during inspiration and cooling it during expiration (thermocycling).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Sedaconda-ACD-S (Sedana Medical, Danderyd, Sweden) was connected between an intensive care ventilator and a test lung. Liquid isoflurane was infused into the device at 0.5, 1.0, 2.0 and 5.0\u00a0mL\/h; ventilator settings were 500\u00a0mL tidal volume, 12\u00a0bpm, 21% oxygen. Isoflurane concentrations were measured inside the test lung after equilibration. Thermocycling was achieved by heating the breathing gas in the inspiratory hose to 37\u00a0\u00b0C via a heated humidifier without water. Breathing gas expired from the test lung was cooled to 14\u00a0\u00b0C before reaching the ACD-S. In the test lung, body temperature pressure saturated conditions prevailed. Isoflurane concentrations and reflective efficiency were compared between thermocycling and control conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>With thermocycling higher isoflurane concentrations in the test lung were measured for all infusion rates studied. Interpolation of data showed that for achieving 0.4 (0.6) Vol% isoflurane, the infusion rate can be reduced from 1.2 to 0.7 (2.0 to 1.2) mL\/h or else to 56% (58%) of control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Thermocycling of the anaesthetic gas considerably increases the efficiency of the anaesthetic reflector and reduces anaesthetic consumption by almost half in a test lung model. Given that cooling can be miniaturized, this method carries a potential for further saving anaesthetics in clinical practice in the operating theatre as well as for inhaled sedation in the ICU.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10877-022-00967-2","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T03:03:11Z","timestamp":1673319791000},"page":"919-924","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Increasing the reflection efficiency of the Sedaconda ACD-S by heating and cooling the anaesthetic reflector: a bench study using a test lung"],"prefix":"10.1007","volume":"37","author":[{"given":"Andreas","family":"Meiser","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre Louis Fernando","family":"Meis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"O\u2019Gara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Volk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azzeddine","family":"Kermad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"967_CR1","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.1097\/01.CCM.0000145951.76082.77","volume":"32","author":"PV Sackey","year":"2004","unstructured":"Sackey PV, Martling CR, Granath F, Radell PJ. Prolonged isoflurane sedation of intensive care unit patients with the Anesthetic Conserving Device. Crit Care Med. 2004;32:2241\u20136.","journal-title":"Crit Care Med"},{"key":"967_CR2","first-page":"1295","volume":"53","author":"E L\u2019Her","year":"2008","unstructured":"L\u2019Her E, Dy L, Pili R, et al. Feasibility and potential cost\/benefit of routine isoflurane sedation using an anesthetic-conserving device: a prospective observational study. Respir Care. 2008;53:1295\u2013303.","journal-title":"Respir Care"},{"key":"967_CR3","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1164\/rccm.201512-2435CP","volume":"193","author":"A Jerath","year":"2016","unstructured":"Jerath A, Parotto M, Wasowicz M, Ferguson ND. Volatile anesthetics is a new player emerging in critical care sedation? Am J Respir Crit Care Med. 2016;193:1202\u201312.","journal-title":"Am J Respir Crit Care Med"},{"key":"967_CR4","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1016\/j.annfar.2008.04.021","volume":"27","author":"P Sauder","year":"2008","unstructured":"Sauder P, Andreoletti M, Cambonie G, et al. S\u00e9dation-analg\u00e9sie en r\u00e9animation (nouveau-n\u00e9 exclu). Annales Francaises d\u2019Anesthesie et de Reanimation. 2008;27:541\u201351.","journal-title":"Annales Francaises d\u2019Anesthesie et de Reanimation"},{"key":"967_CR5","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1016\/j.medine.2013.04.002","volume":"37","author":"E Celis-Rodr\u00edguez","year":"2013","unstructured":"Celis-Rodr\u00edguez E, Birchenall C, de la Cal M\u00c1, et al. Clinical practice guidelines for evidence-based management of sedoanalgesia in critically ill adult patients. Medicina Intensiva (English Edition). 2013;37:519\u201374.","journal-title":"Medicina Intensiva (English Edition)"},{"key":"967_CR6","unstructured":"Analgesie. Sedierung und Delirmanagement in der Intensivmedizin (DAS-Leitlinie). 2021. https:\/\/www.awmf.org\/leitlinien\/detail\/ll\/001-012.html. Accessed 7 Feb 2022."},{"key":"967_CR7","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1016\/S2213-2600(21)00323-4","volume":"9","author":"A Meiser","year":"2021","unstructured":"Meiser A, Volk T, Wallenborn J, et al. Inhaled isoflurane via the anaesthetic conserving device versus propofol for sedation of invasively ventilated patients in intensive care units in Germany and Slovenia: an open-label, phase 3, randomised controlled, non-inferiority trial. Lancet Respir Med. 2021;9:1231\u201340.","journal-title":"Lancet Respir Med"},{"key":"967_CR8","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1007\/s00540-021-02960-6","volume":"35","author":"A Kermad","year":"2021","unstructured":"Kermad A, Speltz J, Danziger G, et al. Comparison of isoflurane and propofol sedation in critically ill COVID-19 patients-a retrospective chart review. J Anesth. 2021;35:625\u201332.","journal-title":"J Anesth"},{"key":"967_CR9","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.jcrc.2020.09.009","volume":"63","author":"N Ferri\u00e8re","year":"2021","unstructured":"Ferri\u00e8re N, Bodenes L, Bailly P, L\u2019Her E. Shortage of anesthetics: think of inhaled sedation! J Crit Care. 2021;63:104\u20135.","journal-title":"J Crit Care"},{"key":"967_CR10","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.bja.2020.04.076","volume":"125","author":"GJ Nieuwenhuijs-Moeke","year":"2020","unstructured":"Nieuwenhuijs-Moeke GJ, Jainandunsing JS, Struys MMRF. Sevoflurane, a sigh of relief in COVID-19? Br J Anaesth. 2020;125:118\u201321.","journal-title":"Br J Anaesth"},{"key":"967_CR11","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1213\/ANE.0b013e3181e058d7","volume":"111","author":"SM Ryan","year":"2010","unstructured":"Ryan SM, Nielsen CJ. Global warming potential of inhaled anesthetics: application to clinical use. Anesth Analg. 2010;111:92\u20138.","journal-title":"Anesth Analg"},{"key":"967_CR12","unstructured":"Anaesthetic Conserving Device - Instructions for use. https:\/\/www.sedanamedical.com\/wp-content\/uploads\/2017\/08\/Anaconda_IFU_English.pdf. Accessed 4 Sept 2019."},{"key":"967_CR13","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s10877-008-9158-4","volume":"23","author":"A Meiser","year":"2009","unstructured":"Meiser A, Bellgardt M, Belda J, R\u00f6hm K, Laubenthal H, Sirtl C. Technical performance and reflection capacity of the anaesthetic conserving device\u2014a bench study with isoflurane and sevoflurane. J Clin Monit Comput. 2009;23:11\u20139.","journal-title":"J Clin Monit Comput"},{"key":"967_CR14","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1080\/17434440.2021.1865151","volume":"18","author":"A Kermad","year":"2021","unstructured":"Kermad A, Speltz J, Daume P, Volk T, Meiser A. Reflection efficiencies of AnaConDa-S and AnaConDa-100 for isoflurane under dry laboratory and simulated clinical conditions: a bench study using a test lung. Expert Rev Med Devices. 2021;18:189\u201395.","journal-title":"Expert Rev Med Devices"},{"key":"967_CR15","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1007\/s10877-016-9902-0","volume":"32","author":"H Bomberg","year":"2018","unstructured":"Bomberg H, Wessendorf M, Bellgardt M, et al. Evaluating the efficiency of desflurane reflection in two commercially available reflectors. J Clin Monit Comput. 2018;32:605\u201314.","journal-title":"J Clin Monit Comput"},{"key":"967_CR16","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1213\/ANE.0000000000003452","volume":"129","author":"H Bomberg","year":"2019","unstructured":"Bomberg H, Meiser F, Daume P, et al. Halving the volume of AnaConDa: evaluation of a new small-volume anesthetic reflector in a test lung model. Anesth Analg. 2019;129:371\u20139.","journal-title":"Anesth Analg"},{"key":"967_CR17","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1213\/00000539-199406000-00022","volume":"78","author":"MJ Laster","year":"1994","unstructured":"Laster MJ, Fang Z, Eger EI 2nd. Specific gravities of desflurane, enfluran, halothane, isoflurane, and sevoflurane. Anesth Analg. 1994;78:1152\u20133.","journal-title":"Anesth Analg"},{"key":"967_CR18","first-page":"89","volume":"6","author":"R Thomasson","year":"1989","unstructured":"Thomasson R, Luttropp HH, Werner O. A reflection filter for isoflurane and other anaesthetic vapours. Eur J Anaesthesiol. 1989;6:89\u201394.","journal-title":"Eur J Anaesthesiol"},{"key":"967_CR19","doi-asserted-by":"publisher","first-page":"105411","DOI":"10.1016\/j.resconrec.2021.105411","volume":"167","author":"X Hu","year":"2021","unstructured":"Hu X, Pierce JMT, Taylor T, Morrissey K. The carbon footprint of general anaesthetics: a case study in the UK. Resour Conserv Recycl. 2021;167:105411.","journal-title":"Resour Conserv Recycl"},{"key":"967_CR20","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s10877-017-0096-x","volume":"32","author":"H Bomberg","year":"2018","unstructured":"Bomberg H, Volk T, Groesdonk HV, Meiser A. Efficient application of volatile anaesthetics: total rebreathing or specific reflection? J Clin Monit Comput. 2018;32:615\u201322.","journal-title":"J Clin Monit Comput"},{"key":"967_CR21","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1213\/ANE.0000000000005074","volume":"132","author":"A Kermad","year":"2021","unstructured":"Kermad A, Appenzeller M, Morinello E, et al. Reflection versus rebreathing for administration of sevoflurane during minor gynecological surgery. Anesth Analg. 2021;132:1042\u201350.","journal-title":"Anesth Analg"}],"container-title":["Journal of Clinical Monitoring and Computing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10877-022-00967-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10877-022-00967-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10877-022-00967-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T17:55:45Z","timestamp":1693504545000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10877-022-00967-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,10]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["967"],"URL":"https:\/\/doi.org\/10.1007\/s10877-022-00967-2","relation":{},"ISSN":["1387-1307","1573-2614"],"issn-type":[{"value":"1387-1307","type":"print"},{"value":"1573-2614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,10]]},"assertion":[{"value":"19 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 December 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 January 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Andreas Meiser, MD PhD: received consulting fees from Sedana Medical (Danderyd, Sweden) and honoraria for lectures from Pall Corporation (Dreieich, Germany). Pierre Louis Fernando Meis, Cand. Med.: the presented data are part of his doctoral thesis. Brian O\u2019Gara: Received consulting fees from Sedana Medical (Danderyd, Sweden). Thomas Volk, MD PhD: received consulting fees from Sedana Medical (Danderyd, Sweden). Azzeddine Kermad, MD DESA: received consulting fees from Sedana Medical (Danderyd, Sweden).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}