{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T15:22:11Z","timestamp":1793200931590,"version":"4.5.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T00:00:00Z","timestamp":1639353600000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Hochschule Hannover (MHH)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Patients at risk of malignant hyperthermia need trigger-free anesthesia. Therefore, anesthesia machines prepared for safe use in predisposed patients should be free of volatile anesthetics. The washout time depends on the composition of rubber and plastic in the anesthesia machine. Therefore, new anesthesia machines should be evaluated regarding the safe preparation for trigger-free anesthesia. This study investigates wash out procedures of volatile anesthetics for two new anesthetic workstations: Dr\u00e4ger Atlan A350 and General Electric Healthcare (GE) Carestation 650 and compare it with preparation using activated charcoal filters (ACF).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A Dr\u00e4ger Atlan and a Carestation 650 were contaminated with 4% sevoflurane for 90\u2009min. The machines were decontaminated with method (M1): using ACF, method 2 (M2): a wash out method that included exchange of internal parts, breathing circuits and soda lime canister followed by ventilating a test lung using a preliminary protocol provided by Dr\u00e4ger or method 3 (M3): a universal wash out instruction of GE, method 4 (M4): M3 plus exchange of breathing system and bellows. Decontamination was followed by a simulated trigger-free ventilation. All experiments were repeated with 8% desflurane contaminated machines. Volatile anesthetics were detected with a closed gas loop high-resolution ion mobility spectrometer with gas chromatographic pre-separation attached to the bacterial filter of the breathing circuits. Primary outcome was time until &lt;\u20095\u2009ppm of volatile anesthetics and total preparation time.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Time to &lt;\u20095\u2009ppm for the Atlan was 17\u2009min (desflurane) and 50\u2009min (sevoflurane), wash out continued for a total of 60\u2009min according to protocol resulting in a total preparation time of 96-122\u2009min. The Carestation needed 66\u2009min (desflurane) and 24\u2009min (sevoflurane) which could be abbreviated to 24\u2009min (desflurane) if breathing system and bellows were changed. Total preparation time was 30-73\u2009min. When using active charcoal filters time to &lt;\u20095\u2009ppm was 0\u2009min for both machines, and total preparation time\u2009&lt;\u20095\u2009min.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Both wash out protocols resulted in a significant reduction of trace gas concentrations. However, due to the complexity of the protocols and prolonged total preparation time, feasibility in clinical practice remains questionable. Especially when time is limited preparation of the anesthetic machines using ACF remain superior.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-021-01533-0","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T06:02:27Z","timestamp":1639375347000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Preparation of Dr\u00e4ger Atlan A350 and General Electric Healthcare Carestation 650 anesthesia workstations for malignant hyperthermia susceptible patients"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5742-5558","authenticated-orcid":false,"given":"Sebastian","family":"Heiderich","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Thoben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3831-1608","authenticated-orcid":false,"given":"Nils","family":"Dennhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terence","family":"Krau\u00df","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5850-7443","authenticated-orcid":false,"given":"Robert","family":"S\u00fcmpelmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Zimmermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Reitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"R\u00fcffert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,13]]},"reference":[{"issue":"1","key":"1533_CR1","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/ALN.0b013e3181ee2cb7","volume":"114","author":"TW Kim","year":"2011","unstructured":"Kim TW, Nemergut ME. Preparation of modern anesthesia workstations for malignant hyperthermia-susceptible patients: a review of past and present practice. Anesthesiology. 2011;114(1):205\u201312.","journal-title":"Anesthesiology"},{"issue":"1","key":"1533_CR2","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/j.bja.2020.09.029","volume":"126","author":"H R\u00fcffert","year":"2021","unstructured":"R\u00fcffert H, Bastian B, Bendixen D, Girard T, Heiderich S, Hellblom A, et al. Consensus guidelines on perioperative management of malignant hyperthermia suspected or susceptible patients from the European malignant hyperthermia group. Br J Anaesth. 2021;126(1):120\u201330.","journal-title":"Br J Anaesth"},{"issue":"1","key":"1533_CR3","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1213\/ANE.0000000000003441","volume":"129","author":"VM Neira","year":"2019","unstructured":"Neira VM, Al Madhoun W, Ghaffari K, Barrowman N, Berrigan P, Splinter W. Efficacy of malignant hyperthermia Association of the United States-Recommended Methods of preparation for malignant hyperthermia-susceptible patients using Drager Zeus anesthesia workstations and associated costs. Anesth Analg. 2019;129(1):74\u201383.","journal-title":"Anesth Analg"},{"issue":"9","key":"1533_CR4","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1111\/aas.13675","volume":"64","author":"LM Muller-Wirtz","year":"2020","unstructured":"Muller-Wirtz LM, Meiser A, Kermad A, Godsch C, Sessler DI, Volk T, et al. Response by the authors, reflection of volatile anesthetic by the vapor-clean filter. Acta Anaesthesiol Scand. 2020;64(9):1383\u20134.","journal-title":"Acta Anaesthesiol Scand"},{"issue":"1","key":"1533_CR5","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1213\/ANE.0000000000000208","volume":"119","author":"N Cottron","year":"2014","unstructured":"Cottron N, Larcher C, Sommet A, Fesseau R, Alacoque X, Minville V, et al. The sevoflurane washout profile of seven recent anesthesia workstations for malignant hyperthermia-susceptible adults and infants: a bench test study. Anesth Analg. 2014;119(1):67\u201375.","journal-title":"Anesth Analg"},{"key":"1533_CR6","volume-title":"GE Healthcare non-clinical internal lab test report number DOC0994043","author":"T Kim","year":"2011","unstructured":"Kim T, Tham R. GE Healthcare non-clinical internal lab test report number DOC0994043; 2011."},{"issue":"11","key":"1533_CR7","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1097\/EJA.0000000000001086","volume":"36","author":"C Thoben","year":"2019","unstructured":"Thoben C, Dennhardt N, Krau\u00df T, S\u00fcmpelmann R, Zimmermann S, R\u00fcffert H, et al. Preparation of anaesthesia workstation for trigger-free anaesthesia: an observational laboratory study. 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Eur J Anaesthesiol. 2018;35(7):534\u20138.","journal-title":"Eur J Anaesthesiol"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-021-01533-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-021-01533-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-021-01533-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T06:03:03Z","timestamp":1639375383000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-021-01533-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1533"],"URL":"https:\/\/doi.org\/10.1186\/s12871-021-01533-0","relation":{},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"20 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"As there were no humans or animals involved, no ethical approval was necessary for this laboratory technical study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"R. S. received fees for speeches and funds for research from B. Braun Melsungen AG, Melsungen, Germany. SH, CT, ND, TK, SZ, MR and HR have no conflicts of interests to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"315"}}