Questions and Answers
1. What kind of ventilators can be used with the AnaConDa?
AnaConDa can be used with almost any kind of ventilator, with the exception of high frequency ventilators which have not been tested for use with the device.
2. How long can the AnaConDa be used for?
AnaConDa is intended for single use only and needs to be replaced every 24 hours, or when needed. Example, if unexpected events occur such as sudden blockage of the airways due to excessive secretion, etc.
3. Can N2O be used in the gas mixture with the AnaConDa?
AnaConDa is not approved for use with N2O.
4. What type of Syringe pumps should I use?
The syringe pump should be CE marked and programmable for delivery of pharmaceutical drugs and should have settings for Sherwood Monoject or Becton Dickinson Plastipak 50/60 ml syringes.
5. Which anaesthetic agents can be used with AnaConDa?
Either Isoflurane or Sevoflurane can be used.
6. Can AnaConDa be used in paediatric patients?
AnaConDa is not approved for paediatric use.
7. Can other syringes be used with the AnaConDa?
No, the AnaConDa Syringe has been tested and validated for use with Isoflurane or Sevoflurane. The connector on the syringe is unique, and can only be connected to the Sedana Filling Adaptors and the AnaConDa agent line.
8. What is a MAC and Fet% value?
The minimal alveolar concentration (MAC) is the alveolar concentration of an inhaled anaesthetic at one atmosphere that prevents skeletal muscle movement in response to a noxious stimulus in 50% of patients. MAC represents a relative measure of the level of anaesthesia. It can be used to compare inhaled anaesthetics and is a useful index of anaesthetic potency. MAC also corresponds to Fet% and viceversa.
9. Can a nebulizer be used with AnaConDa?
It is possible to use a jet nebulizer or ultrasonic nebulizer with AnaConDa. The nebulizer should be connected between the patient and AnaConDa. Ultrasonic nebulisers are preferable as they do not add extra airflow. If a jet nebuliser is connected it may be necessary to increase the syringe pump rate to compensate for the extra flow from the nebuliser. Extra flow may decrease the gas concentration. Please refer to the relevant manufacture for compatibility with volatile anaesthetics.
Note. Repeated nebulisations may increase the flow resistance of the AnaConDa. Pay attention to signs of occlusions. Always consider the increased dead space when connecting extra items.
10. What happens if the AnaConDa is positioned with the gas samplings port facing downwards?
This will increase the risk of excess condensation in the gas sampling line which may distort the Fet/MAC measurement of the gas and lead to incorrect readings.
11. Why can Desflurane not be used with AnaConDa?
Desflurane has a low boiling point (22.8°C). The administration via a Syringe and Syringe Pump is not possible.
12. What type of gas sampling tube can be used?
Always refer to the gas monitor manual regarding which sampling line to use. Connecting the incorrect type or length of tube may cause incorrect Fet/MAC readings from the gas monitor.
13. Why is the Fet value higher than the Fi value?
The highest gas concentration occurs at the start of the inspiration cycle when the recycled gas is mixed with the fresh gas from the AnaConDa evaporator. However this represents a short peak and the concentration decreases rapidly to its lowest point at the end of inspiration. Most monitors show a Fi value which is measured at the end of inspiration thus showing a low value when using the AnaConDa. The expiratory values are measured at the end of expiration which gives the value of alveolar concentration.
14. Can pressure support ventilation be used with the AnaConDa?
Yes, but there may be some changes in concentration. Normal fluctuations during pressure support ventilation do not change the gas concentration in any significant way.
15. Can AnaConDa be temporary stopped?
Yes, the syringe pump needs to be stopped and the gas sampling line disconnected. First disconnect the AnaConDa from the Y-piece and then from the ET-tube. It is vitally important to disconnect or stop the gas monitor as it draws between 50-200 ml/min of gas. The ventilator side of the AnaConDa and gas monitor port should then be closed with the respective caps. When reconnecting the patient please follow the Instructions for Use.
16. What is the best way of performing suctioning?
It is preferable to use a closed suctioning system or a swivel adaptor with a suction port. If disconnecting AnaConDa during suctioning, the inspiration pause function on the ventilator can be used.
17. Can the AnaConDa be used with Active Humidification?
No, active humidification is contraindicated with AnaConDa.
18. What is the environmental exposure when using anaesthetic agents?
As part of the manufacturing process every AnaConDa device is leak tested. Recent studies have shown that there is no risk of exposure to patients or health care professionals when using the AnaConDa and the FlurAbsorb filter.