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Flashcards in CO2 Absorption Deck (30)
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1

Why absorb CO2?

1. To reuse volatile anesthetics in an anesthetic circuit carbon dioxide absorption is required (Cannot just pump CO2 and gas out the window- too expensive. Want to rebreathe expensive anesthetics as well)
2. Carbon dioxide absorption is also critical in other enclosed environments such as submarines and space vehicles

2

Carbon dioxide is a end product of?

1. Metabolism that is kept low in the body by its expiration
2. Normal PCO2 levels are:
- 40 mmHg (arterial)
- 45 mmHg (venous)

3

Human CO2 production?

1. Approximately 4 ml per minute per kg of body weight

4

Basis of carbon dioxide absorption is its ability to form _____ in water?

1. Form carbonic acid in water

5

Carbon Dioxide Reaction in body

1. CO2 + H2O H2CO3 H+ + HCO3 (bicarbonate)
In acidic environment, carbonic acid will give up proton

2. H+ + HCO3- ---> 2 H+ + CO3 -2 (carbonate)
In basic enough environment, bicarbonate will release protons to make carbonate

6

Upon reacting with water, carbon dioxide does what?

1. Goes from volatile gas to a non volatile carbonate form
2. Note that CO2 can form 2 different anions

7

Non Volatile Carbonate Salts

1. The basis of irreversible carbon dioxide absorption is its ability to react with water to ultimately form non volatile carbons
2. Non volatile carbonate salts can be formed with various cations
Examples:
- Na2CO3 (reversible)
-CaCO3 (irreversible)
- BaCO3 (reversible)

8

Soda Lime Reactions (2)

1. 2 H2CO3 + 2 NaOH + 2 KOH ---> Na2CO3 + K2CO2 + 4 H2O + Heat
2. 2 Ca (OH)2 + Na2CO3 + K2CO3 --> 2 CaCO3 + 2 NaOH + 2 KOH + Heat
-CO2 reaction with Ca(OH)2 is slow, but it is faster with NaOH
- Calcium Hydroxide forms Calcium Bicarbonate with is irreversible*

9

Role of water in CO2 absorption

1. Because water is critical to absorption, decreased CO2 absorption occurs below a water content of 12%
2. Decreased absorption also occurs above 20% water content

10

Temperature and CO2 absorption

1. The core of soda lime canisters usually reaches temperatures of 40-45 C. Sides are cooler
2. Do not use temperature as guide though*

11

Reactions of Carbon Dioxide with Ba(OH)2 in baralyme:

1. Not used much in this country
2. Ba(OH)2 is in the form OF octahedral even in baralyme.
3. Baralyme may perform better in drier conditions

12

Composition of Soda Lime (Sodasorb)

1. Calcium Hydroxide: 79%
2. Sodium Hydroxide: 1.2%
3. Potassium Hydroxide: 2.3 (activator)
4. Moisture content: 13.6%
5. Indicator (ethyl violet): 0.06%
Plus small amounts of silica to form Ca++ and Na+ silicates for hardness and binding*

13

Composition of Baralyme

1. Calcium Hydroxide: 69%
2. Barium Hydroxide: 10.4%
3. Potassium Hydroxide: 4.6%
4. Water: 13.7%
5. Indicator (ethyl violet): 0.15%
*also contains silicates for hardness. Baralyme is more dense than Soda Lime and 15% less efficient, releases more water

14

Small facts about Sodalime label

1. Pretty basic actually
2. Reacts with skin a little bit, will want to wash your hands after contact (will become soapy and slippery
3. Prolonged exposure to direct UV light may deplete the ethylviolet indicator

15

CO2 absorption characteristics of soda lime

1. In a properly packed canister, 15L of CO2 will be absorbed per 100 g of soda lime, before exit gas exceeds 1% CO2.
2. For an 8 hour operation, approximately 1 kg of sodalime is needed

16

Factors that can reduce absorption efficiency:

1. Channeling (uneven flow through soda lime)- all gas goes to one side and not the other, gas goes towards big particles because there's less resistance
2. High gas flows, decreased CO2 residency time
3. Caking- another form of channeling, particles stick together
4. Decreased moisture
*newer absorbants are better- minimize reactions with anestheticsi

17

Newer CO2 absorbent: Amsorb

1. Greatly decreases sevo and des breakdown
2. Accomplishes this by not containing the strong bases NaOh and KOH
3. Consists of calcium hydroxide with a compatible humectant, calcium chloride. The absorbent mixture does not contain sodium or potassium hydroxide, but includes two setting agents (calcium sulfate and polyvinylpyrrolidine) to improve hardness and porosity
4. Sodasorb LF (low flow) also does NOT contain NaOH****

18

Size of granules:

1. Size of determined experimentally and is a function of resistant to air flow and absorptive efficiency
2. Sodalime and baralyme granules are between 4 and 8 mesh

19

Mesh:

1. Number of openings per linear inch in a sieve through which the particles can pass
A- 4-Mesh (four 1/4th inch openings per inch)
B- 8- Mesh (eight 1/8th inch openings per inch)
2. 4-8 mesh allows for maximum surface area and exposure, and low flow resistance*

20

Shape:

1. To increase surface area, and thus absorption efficiency,
Granules are made porous and irregular shaped. New granules are cylindrical in shape
2. Silica is added to Sodalime to make granules harder and to reduce DUST formation

21

Irregularity vs Cylindral granules

1. Irregularity works to your favor: more twists and turns= more absorption of CO2 capacity

22

Dye Indicator

1. Ethyl violet is used in sodalime and baralyme
2. Critical pH of ethyl violet is 10.3
3. Above 10.3 the dye is colorless, below dye turns purple
4. pH drops as the soda lime is exhausted because the very basic NaOH is depleted

23

Color Change:

1. CO2 absorption is a chemical reaction: removes CO2 from the gas flowing around granules in the canister. Reaction produces heat and moisture
2. Exhaustion of CO2: absorber no longer is able to absorb CO2, indicated by color change (to violet)
Indicated by increasing ETCO2 monitoring level (>.5% ETCO2)
4. Color change requires moisture: absorbent can dry out (desiccate) if: exposed to constant gas flow for long periods of time, exposed to substantial heat (color change can reverse making it appear like absorbent is unused)

24

Why circuits get wet?

1. Average adult exhales CO2= 200 ml/min at rest
2. When absorbed, this CO2 produces 8.6 ml of H2O/hr or in 8 hours of use= 70 ml of H20

25

Potential Deactivation of ethyl violet: (4)

1. Fluorescent lights can slowly deactivate ethyl violet
2. Intense ultraviolet light can reactive ethyl violet
3. Ethyl violet can deactivate over long periods of time. Oxygen flushes will allow oxidation of the dye. Oxygen flush, in addition to oxidizing the dye will dehydrate the absorbent
4. Severe moisture loss will deplete effectiveness of the dye

26

Color reversion:

1. After setting for several hours following use, subsurface Ca(OH2) may allow dye to revert to colorless. This is due to granule surface pH increasing > 10.3
2. This may occur when soda lime is near exhaustion. Soda lime does not regenerate

27

Color change duration

1. Color change intensity fades, but color is still clearly visible after 12 hours
2. Color can remain visible in the canister for months- color change is long lasting

28

Canister Temperature:

1. As noted, absorption is accompanied by heat. However, do not rely on the heat of the soda lime canister as an indicator of soda lime effectiveness.
2. Localized heat is dependent not only generation, but gas flow rate, temperature of the OR, etc. Canister may remain warm even after soda lime is exhausted

29

Unwanted reactions of anesthetics with carbon dioxide absorbents:

1. Volatile fluoridated anesthetics can react with carbon dioxide absorbents to result in:
- carbon monoxide formation (particularly w/ desflurane)
- degradation products for sevo, i.e. Compound A, B, C, D and E, but mostly A
- Extreme heat and fire has been reported to occur (particularly with sevo and baralyme)

30

Amsorb does not contain the strong bases (what 2)?

1. NaOH
2. KOH