3. Only by eliminating both KOH and NaOH from the absorbent is no compound A produced; thus, we can comply with the message about “putting the brakes on anesthetic breakdown” of a recent editorial on that subject. DURING sevoflurane anesthesia, particularly in low-flow and closed-system procedures, compound A can be formed. How long will it take to cook a 12 pound turkey? How will understanding of attitudes and predisposition enhance teaching? An interesting finding is also that the amount of liquid sevoflurane injected in the system to generate a stable end-tidal concentration of sevoflurane was significantly less (P < 0.05) in the presence of Amsorb than with all the other absorbents. 12However, Medisorb contained only 1% NaOH, and Drägersorb 800 plus, 2% NaOH (such as was contained in Drägersorb 800 also), whereas in the KOH-free Sodasorb we studied, there was 3.75% NaOH. Anesthesiology 1997; 86: 1225–7, Neumann MA, Laster MJ, Weiskopf RB, Gong DH, Dudziak R, Förster H, Eger EI II: The elimination of sodium and potassium hydroxides from desiccated soda lime diminishes degradation of desflurane to carbon monoxide and sevoflurane to compound A but does not compromise carbon dioxide absorption. A modified PhysioFlex apparatus (Dräger, Lübeck, Germany) was connected to an artificial test lung (inflow at the top of the bellow approximately/= 160 ml/min CO2; outflow at the Y piece of the lung model approximately/= 200 ml/min, simulating oxygen consumption). The canister temperatures were almost the same for all absorbents examined, with T°outhigher than T°in; the only exception was with lithium hydroxide, which generated much higher temperatures (P < 0.05), with T°induring the first 120 min higher than T°out. With KOH-free (but sodium hydroxide [NaOH]-containing) soda limes even higher compound A concentrations are recorded than with standard Sodasorb. 9These findings were a strong argument for our group to study in detail KOH-free absorbents. The reason for this difference is not clear, but such a reaction has also been observed by other authors. To measure compound Ainsp concentration in the inspired gas of the breathing circuit, 2-ml gas samples were taken and analyzed by capillary gas chromatography plus mass spectrometry. Linda F. M. Versichelen, Marie-Paule L. A. Bouche, Georges Rolly, Jan F. P. Van Bocxlaer, Michel M. R. F. Struys, André P. De Leenheer, Eric P. Mortier; Only Carbon Dioxide Absorbents Free of Both NaOH and KOH Do Not Generate Compound A during In Vitro  Closed-system Sevoflurane: Evaluation of Five Absorbents. 2KOH + CO2 ----> K2CO3 + H2O Increases in the weight of U-tube containing KOH gives the weight of CO2 produced and form the weight of the CO2 obtained , 4reported that absorbents differently eliminated sevoflurane from the outflow in their setup. Technically, we could not measure the sevoflurane concentrations at the inlet and outlet of the absorbent canister, so, for the time being, we can only speculate on the exact reasons. Anesthesiology 2001; 95:750–755 doi: https://doi.org/10.1097/00000542-200109000-00030. This gas was brought to a stand-alone Ultima gas analyzer (Datex, Helsinki, Finland) for measuring all respiratory gases. A significant correlation (P < 0.05) was found between compound Ainspvalues and canister T°outin the Sofnolime (r = 0.49) group only. Only by eliminating KOH as well as NaOH from the absorbent (Amsorb and lithium hydroxide) is no compound A produced. The small concentration of compound A (4 or 5 ppm) that was present initially in the first Sodasorb group to be examined was generated by the minimal quantity of 0.2% sevoflurane which we had to introduce into the circuit to close electronically the charcoal canister present in the PhysioFlex machine. At the end of the preparation of the experimental setup and 5, 15, 30, 60, 90, 120, 150, 180, 210, and 240 min after the start of sevoflurane administration, data on end-tidal carbon dioxide partial pressure, end-tidal sevoflurane concentration, T°in, T°out, compound Ainsp, and compound Aexpwere recorded. 2–4In the soda limes of the various manufacturing companies, sodium hydroxide (NaOH) and potassium hydroxide (KOH) are mostly used as initiators in the carbon dioxide chemical binding process. Spearman correlation coefficients were calculated between canister T°in, canister T°out, and compound Ainsp. To correct for multiple pairwise comparisons between the five groups, the statistical significance for the Wilcoxon rank sum test was set at P < 0.01. A possible explanation is that the absorbents not only degrade sevoflurane to compound A, but also degrade the compound A formed. The aim of this study was to measure the formation of compound A during in vitro  closed-system sevoflurane administration, using five different carbon dioxide absorbents whereby results were obtained during a previous study performed in the department in almost identical circumstances 6: (1) KOH-free soda limes (Sofnolime and KOH-free Sodasorb; Molecular Products, Thaxted, UK, and Grace, Epernon, France, respectively); (2) NaOH-free and KOH-free absorbents (Amsorb 5; and lithium hydroxide; Armstrong, Coleraine, Northern Ireland and Chemetall, Frankfurt, Germany, respectively); and (3) classic sodalime Sodasorb (Grace). In a detailed study on carbon monoxide formation from volatile anesthetics, it was also reported that KOH was more reactive than NaOH. Our results with the KOH-free but NaOH-containing limes are in conflict with those of a recent report, 12in which less compound A was generated with the KOH-free (0.003% KOH) sodalimes Drägersorb 800 plus and Medisorb (Datex-Ohmeda, Bromma, Sweden), than with the classic Drägersorb 800. Unanswered Questions. In contrast, Cunningham et al. KOH solutions are used to absorb CO2 from air via the following reaction: CO 2 (g) + KOH(aq) --> K 2 CO 3 (aq)+H 2 O(l) How many liters of gaseous CO 2 can be absorbed by the solution made via dissolving 15 g of the base in 200 g of H 2 O if p(CO 2)= 1 atm and T= 22° C After reaching their peak concentration, a decrease for Sofnolime, KOH-free Sodasorb, and Sodasorb until 240 min was found. Who of the proclaimers was married to a little person? All Rights Reserved. The result is potassium bicarbonate and water. The median (range, minimum and maximum) values for lithium hydroxide and Sodasorb are shown.

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