In vitro validation of a Pitot-based flow meter for the measurement of respiratory volume and flow in large animal anaesthesia.

OBJECTIVE: To remodel and validate commercially available monitors and their Pitot tube-based flow sensors for use in large animals, using in vitro techniques. STUDY DESIGN: Prospective, in vitro experiment. METHODS: Both the original and the remodelled sensor were studied with a reference flow generator. Measurements were taken of the static flow-pressure relationship and linearity of the flow signal. Sensor airway resistance was calculated. Following recalibration of the host monitor, volumes ranging from 1 to 7 L were generated by a calibration syringe, and bias and precision of spirometric volume was determined. Where manual recalibration was not available, a conversion factor for volume measurement was determined. The influence of gas composition mixture and peak flow on the conversion factor was studied. RESULTS: Both the original and the remodelled sensor showed similar static flow-pressure relationships and linearity of the flow signal. Mean bias (%) of displayed values compared with the reference volume of 3, 5 and 7 L varied between -0.4% and +2.4%, and this was significantly smaller than that for 1 L (4.8% to +5.0%). Conversion factors for 3, 5 and 7 L were very similar (mean 6.00 +/- 0.2, range 5.91-6.06) and were not significantly influenced by the gas mixture used. Increasing peak flow caused a small decrease in the conversion factor. Volume measurement error and conversion factors for inspiration and expiration were close to identity. CONCLUSION: The combination of the host monitor with the remodelled flow sensor allowed accurate in vitro measurement of flows and volumes in a range expected during large animal anaesthesia. CLINICAL RELEVANCE: This combination has potential as a reliable spirometric monitor for use during large animal anaesthesia.

Isoflurane measurement error using short wavelength infrared techniques in horses: influence of fresh gas flow and pre-anaesthetic food deprivation.

OBJECTIVE: To quantify the isoflurane measurement error arising from the use of short wavelength infrared (IR) anaesthetic gas analysis during low flow anaesthesia in horses. STUDY DESIGN: Prospective clinical study. ANIMAL POPULATION: Sixty-four client-owned horses referred for elective or emergency surgery (age 1-16 years, body mass 400-650 kg). MATERIALS AND METHODS: Horses were divided into four groups based on duration of pre-anaesthetic food deprivation period (FDP) and fresh gas flow during anaesthesia: a high flow group with normal FDP (n = 16) and three groups with low flow and normal (n = 29), long (n = 5) or no (n = 14) FDP, respectively. Circuit isoflurane concentrations were measured simultaneously using a short wavelength (methane-sensitive) analyser (Datex Capnomac Ultima) and a long wavelength (methane-insensitive) analyser (Hewlett Packard M 1025 B) for at least 60 minutes. The difference between the readings of both analysers gave the isoflurane measurement error of short wavelength IR analysis, from which the circuit methane concentration was calculated. RESULTS: In the low flow groups, isoflurane measurement error increased over time, whereas in the high flow group, error remained constant after an initial rise in the first 15 minutes. The isoflurane measurement error was significantly lower (p < 0.005) in the high flow group compared with the low flow-normal FDP group from 15 to 60 minutes. Compared to the low flow - normal FDP group, isoflurane measurement error was significantly smaller (p < 0.001, from 15 to 60 minutes) in the low flow-long FDP group and significantly larger (p = 0.016, at 60 minutes) in the low flow-no FDP group. Within the low flow-no FDP group, values in colic cases did not differ from those in noncolic cases (p > 0.7). CONCLUSIONS: Isoflurane measurement using short wavelength IR absorption is inaccurate. The fresh gas flow and duration of pre-anaesthetic food deprivation influence the isoflurane measurement error during anaesthesia in horses. CLINICAL RELEVANCE: Short wavelength IR analysers are not reliable for isoflurane measurement during (low flow) anaesthesia in horses.