{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T16:04:55Z","timestamp":1757779495635,"version":"3.40.5"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,23]],"date-time":"2020-03-23T00:00:00Z","timestamp":1584921600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005690","name":"Universit\u00e4t des Saarlandes","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005690","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Volatile anesthetics potentially trigger malignant hyperthermia crises in susceptible patients. We therefore aimed to identify preparation procedures for the Draeger Primus that minimize residual concentrations of desflurane and sevoflurane with and without activated charcoal filtration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A Draeger Primus test workstation was primed with 7% desflurane or 2.5% sevoflurane for 2\u00a0hours. Residual anesthetic concentrations were evaluated with five preparation procedures, three fresh gas flow rates, and three distinct applications of activated charcoal filters. Finally, non\u2010exchangeable and autoclaved parts of the workstation were tested for residual emission of volatile anesthetics. Concentrations were measured by multicapillary column\u2013ion mobility spectrometry with limits of detection\/quantification being &lt;1 part per billion (ppb) for desflurane and &lt;2.5\u00a0ppb for sevoflurane.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The best preparation procedure included a flushing period of 10\u00a0minutes between removal and replacement of all parts of the ventilator circuit which immediately produced residual concentrations &lt;5\u00a0ppm. A fresh gas flow of 10\u00a0L\/minute reduced residual concentration as effectively as 18\u00a0L\/minute, whereas flows of 1 or 5\u00a0L\/minute slowed washout. Use of activated charcoal filters immediately reduced and maintained residual concentrations\u00a0&lt;5 ppm for up to 24\u00a0hours irrespective of previous workstation preparation. The fresh gas hose, circle system, and ventilator diaphragm emitted traces of volatile anesthetics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In elective cases, presumably safe concentrations can be obtained by a 10\u2010minute flush at \u226510\u00a0L\/minute between removal and replacement all components of the airway circuit. For emergencies, we recommend using an activated charcoal filter.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13571","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T01:55:30Z","timestamp":1583805330000},"page":"759-765","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Residual volatile anesthetics after workstation preparation and activated charcoal filtration"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7984-1798","authenticated-orcid":false,"given":"Lukas M.","family":"M\u00fcller\u2010Wirtz","sequence":"first","affiliation":[{"name":"Center of Breath Research Department of Anesthesiology Intensive Care and Pain Therapy Saarland University Medical Center Homburg Saarland Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Godsch","sequence":"additional","affiliation":[{"name":"Center of Breath Research Department of Anesthesiology Intensive Care and Pain Therapy Saarland University Medical Center Homburg Saarland Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel I.","family":"Sessler","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research Anesthesiology Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Volk","sequence":"additional","affiliation":[{"name":"Center of Breath Research Department of Anesthesiology Intensive Care and Pain Therapy Saarland University Medical Center Homburg Saarland Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sascha","family":"Kreuer","sequence":"additional","affiliation":[{"name":"Center of Breath Research Department of Anesthesiology Intensive Care and Pain Therapy Saarland University Medical Center Homburg Saarland Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"H\u00fcppe","sequence":"additional","affiliation":[{"name":"Center of Breath Research Department of Anesthesiology Intensive Care and Pain Therapy Saarland University Medical Center Homburg Saarland Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00101-014-2392-x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199306000-00018"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199103000-00020"},{"key":"e_1_2_9_5_1","unstructured":"Malignant Hyperthermia Association of the United States (MHAUS).https:\/\/www.mhaus.org\/"},{"key":"e_1_2_9_6_1","unstructured":"European Malignant Hyperthermia Group (emhg).https:\/\/www.emhg.org\/"},{"key":"e_1_2_9_7_1","first-page":"S287","article-title":"The effect of trace halothane exposure on triggering malignant hyperthermia in susceptible swine","volume":"82","author":"Maccani RM","year":"1996","journal-title":"Anesth 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