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ANESTHESIA MACHINE
Daniela Ortiz Acosta
Resident of 1heyear
Anesthesiology and Perioperative Medicine
University Clinic of La Sabana
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Anesthesia machine

It is a device for pulmonary administration of a controlled dose of

inhalation agents while it is possible to ventilate with positive pressure,
It is possible to eliminate residual gases, as well as to monitor in addition to
the machine's own functions situations that put life at risk
or that do not produce an effective administration.

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Specific Requirements

They administer anesthetic gases in precise doses.

They allow the reutilization of anesthetic gases after separating the

carbon dioxide

Measure the O2 and other gases administered separately.

simultaneously

They continuously enrich the mixture with an adjusted dose of gases.

anesthetics.

They can use a manual breathing mode (ventilation through

"bag"), with the possibility of adjusting the pressure of the circuit.

They eliminate the residual gases from the patient's circuit.

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Specific requirements

They continuously measure the concentration of inhaled oxygen.

They prevent the administration of hypoxic gas mixtures produced.

due to user error or due to alterations in gas input.

They contain a manual oxygen administration system in the

respiratory circuit.

They have a supplementary oxygen system.

They show the pressures of gas supply pipes, as well as of

the reserve bullets

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Components of the anesthesia machine
GAS CONTRIBUTION

Its function is
secure management and measure
of the respiratory gases, in
special of the O2, since the
sources of contribution until the
vaporizer, and from there, to the
respiratory circuit of the patient

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Components of the anesthesia machine
GAS CONTRIBUTION

The gas supply system can be functionally divided

High The section covers from the gas deposits to the regulators.
primary or high pressure.
pressure
2,000 pounds per square inch for cases of O2 and medical air

Pressure Includes the conduction through the hospital ducts (5055 psig) or the
that withstand pressures between 15 and 30 psig when using regulators
intermediate secondary.
:
Low Include the contribution of gases from the flow control valves through the
flow meters (or flow sensors), through the vaporizers, to the
pressure gas discharge to the patient's circuit.

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Components of the anesthesia machine
GAS CONTRIBUTION
High pressure

The bullets connect to the machine

through a yoke
This connection guides the placement of the bullet,
holds it securely, keeps a
hermetic closure between both and ensures the flow
unidirectional towards the machine

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Components of the anesthesia machine
GAS CONTRIBUTION
High pressure

Connection must have a label

that shows the gas that must be housed there

Pin Index Safety System (PISS)

Designed to reduce the risk of disconnection
bullet error when changing them.

Metallic rails placed in a way

that are accommodated in the discounts it presents
valve at the top of the bullet.

Each gas, or combination of them, has

specific placement of the projections

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Components of the anesthesia machine
GAS SUPPLY
Intermediate pressure

The medicinal gases from the central warehouse of

hospitals connect to the anesthesia machine
through connectors with Diameter Index
Safety System (DISS)

They are based on the conformity between the shape of

stem at the end of the gas line and the shape
from the entry cavity of each gas in the
anesthesia machine

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Components of the anesthesia machine
GAS SUPPLY
Intermediate pressure

Oxygen washing valve

The valve allows for manual administration

de O2 al 100% a un flujo alto, directamente
within the patient's circuit.

The supply of O2 is done directly from

the depression circuitin intermediate, and lavavalve
remains closed until the
the professional activates it.

This system is always available, even

when the machine is not turned on

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Components of the anesthesia machine
GAS CONTRIBUTION
Intermediate pressure

Oxygen wash valve

The O2 released by the valve is included in the low-pressure circuit.
beyond the vaporizers, with a flow of between 35 and 75 l/min

Risks in the use of deoxygenating wash valves.

Defective or deteriorated check valve can The inappropriate use of a valve

get stuck in the power position and functioning norm can also produce
to produce barotrauma. problems.

Inspiratory phase with

Valve blocked in a Given that the flow of O2 to An excessive use compression ventilation
intermediate position can washing enthusiast positive can produce
through a valve Intraoperative O2 may
produce the awakening dissolution by
ineffective agent barotrauma if the
intraoperative of the produce brightening of the
inhalatory
patient inhalation agent. machine without limiter
inspiration pressure

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Components of the anesthesia machine
GAS CONTRIBUTION
Intermediate pressure

Pneumatic safety systems: different safety devices that

they minimize the risk of administering a hypoxic mixture in the case of
that the O2 pressure is significantly reduced

Alarm sensor of
failure in the O2 supply 37 - 20 psig

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Components of the anesthesia machine
GAS SUPPLY
Low pressure

It starts at the flow control valves and ends at the point of

gas outlet

The key components are the flow control valves,

flow meters or flow sensors, the connection of the vaporizers and
anesthetic gas vaporizers.

It is the most vulnerable part of the entire gas supply system so that it can be
they produce leaks.

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Components of the anesthesia machine
GAS CONTRIBUTION
Low pressure

Flowmeters.

The professional regulates the flow of gases that enter the

low pressure section when adjusting the flow valves.

Flow valves have been controlled in a

mechanics; however, in the newer machines
controlled by an electronic device.

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Leaks
In the sixties, researchers pointed out that, in case of a leak
in the flow meters, the possibility of administering a hypoxic mixture is
less if the eloxigen was placed as the last gas to be incorporated into the
mix

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SECURITY SYSTEMS

[Link] guard system

System that guarantees a minimum concentration of 25% O2
flow of fresh gases that go to the patient.

2. Basal flow of O2
System that guarantees a minimum flow of 50-350ml/min of O2

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ANESTHETIC VAPORIZERS
Physical phenomena

Dalton's Law of Partial Pressures:

When we host a gas in a container, its molecules bombard the walls.

from the container and create a pressure that is proportional to the number of molecules of
gas present in that space.

Millimeters of mercury (mmHg) or kilopascals (kPa).

When we have a mixture of gases inside a container, each gas produces its
propiapresion, which is the same as if it only occupied the container

The pressure exerted individually by each gas in particular is called

partial pressure.
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ANESTHETIC VAPORIZERS

The total sum of the pressures

partial pressures of the gases that compose
the anesthetic mixture is equal to the
environmental pressure oppression
atmospheric.

At sea level, the atmospheric pressure

it is 760 mmHg, expressed also
as 1 atm or 101,325 kPa.

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Anesthetic Vaporizers
Evaporation and vapor pressure: Inhalational anesthetic agents
they are called volatile because, like other volatile liquids, they are prone
to evaporate or to vaporize.

If this process is carried out in

When an anesthetic agent a closed environment, like the
inhaler, is exposed to air or to evaporation chamber of a
other gases, the molecules This process is known as anesthetic vaporizer flow
present on the surface of the evaporation, which is a phenomenon variable
liquid that has enough simple on the surface. The number of particles that enter the phase
energy escapes from the liquid phase gases will end up balancing with the
and enter the gaseous phase molecules that return to the liquid phase

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ANESTHETIC VAPORIZERS

At this equilibrium point of

The concentration of molecules in evaporation, the molecules of
Substances with a high
the steam remains, then, anesthetic in the vapor phase
constant, and it is then said that tendency to evaporate generates
they are bombing the walls
the gas is "saturated" with the of the container and creating a steam pressure
high.
anesthetic. partial pressure known as
saturated vapor pressure

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ANESTHETIC VAPORIZERS

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ANESTHETIC VAPORIZERS
If the
temperature of a liquid
Vapor pressure is a Steam pressure like the anesthetic agent
physical property of each it depends on the temperature isoflurane, it decreases the
substance, and each one not affected by the evaporation
it has a unique value to a changes in pressure Because the number is reduced
given temperature atmospheric molecules that have the
energy necessary to enter
in the vapor phase.

Conversely, if the
the temperature of the liquid is
raises, improves the
evaporation and rises the
vapor pressure.

Since the values of vapor pressure are unique

for each anesthetic agent, the vaporizers must
to be designed specifically for each agent.

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Gas concentration and
minimal alveolar concentration.
When we describe the proportion of a gas within a mixture, we can refer to a
determined gas through its partial pressure (mmHg) or through a percentage of the volume in relation
with the sum of the volumes of all the gases, what is known as percentage volume or volume-
volume percent (v/v%)

Since the partial pressure is directly proportional to the number of gas molecules that
They are found in the sample, we can use partial pressure as a method to calculate the
volumetric percentage of each of its components

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Minimal alveolar concentration
(CAM)
It is expressed in percentage values.

It is defined as the concentration of an anesthetic gas that prevents the

response in the form of movement to a surgical stimulus in 50% of
the patients

The CAM is a clinically useful value given that the switch of the vaporizers is
marked and calibrated in relation to the concentration of the anesthetic gas. Without
embargo, it is the partial pressure of the anesthetic (in mmHg) in the brain that is
responsible for the depth of anesthesia.

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Boiling point
The boiling point of a liquid is defined as the temperature at which
when the vapor pressure equals the atmospheric pressure and the liquid
start to boil

Desflurane boils at 22.8 °C, a temperature we can encounter in daily clinical practice.
This physical characteristic, along with its high saturated vapor pressure, requires designing a
special vaporizer to control the administration of this agent

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Classification of vaporizers

Modified Dorsch classification

1st By type of flows

2nd •By type of vaporization

3rd By the temperature compensation method

4th •For the type of internal pressure and 5º; For the type of
calibration).

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Classification of vaporizers

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RESPIRATORY CIRCUITS

The fresh gas is part of the gas supply system and enters the circuit.
respiratory through the gas outlet port. The functions of
the respiratory circuit is the administration of oxygen and other gases
to the patient, and the elimination of carbon dioxide

The respiratory circuit must be composed of:

A low resistance duct for gas flow

A gas reserve that can meet the inspiratory needs of the patient.

A port or a respiratory valve that eliminates excess gas

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Circular respiratory systems
The circular system gets its name from the fact that it allows the flow
of gas in a unidirectional manner, which is facilitated by the presence of
check valves.

Among the The maintenance of an inspired gas concentration

advantages of the relatively stable
systems
circulars The conservation of temperature and humidity during the
we found: respiration
3) The elimination of carbon dioxide

4) The saving of anesthetic agents by inhalation

The reduction of air pollution in the operating room.

To allow the re-inhalation of exhaled gases, we must remove carbon dioxide.

produced.
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Circular respiratory systems
Circular systems must also allow for spontaneous ventilation.
manual ventilation and ventilation with positive pressure. Therefore, the system
circular must be able to be used with a reserve bag and with a ventilator.

The circulatory system is made up of several essential components, including:

A source of fresh gas

2) Unidirectional inspiratory valve and another expiratory

3) Some corrugated inspiratory and expiratory tubes

A Y-shaped piece for connection with the patient

5) Excess flow valve or adjustable pressure-limiting (APL, adjustable pressure-limiting)

A bag that serves as a reservoir or that helps during breathing

7) Undeposit that contains the absorbent of carbon dioxide

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Circular respiratory systems

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Circular respiratory systems

*APL:User-adjustable pressure relief valve that eliminates the

excess respiratory gas into the collection circuit and allows for pressure control in
the respiratory system during spontaneous and manual ventilation modes.

If we use the machine fan, the valve is excluded or closed.

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Circular respiratory systems

RESERVE BAG:The anesthesia reserve bag has several functions.

important ones, including:
Serve as a reservoir for exhaled gas and fresh gas
How to manually ventilate or assist during spontaneous breathing
As a form of visual-tactile monitoring of spontaneous respiratory efforts
about a patient
Protecting, at least partially, the patient from excessive positive pressure in the
respiratory circuit, as in the case of an inadvertent closure of the APL valve or of
a blockage in the gas collection circuit

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Circular respiratory systems

PART IN [Link] part of the circuit, blades closest to the patient,

it connects the inspiratory and expiratory arms of the respiratory circuit
circular.
The internal diameter is 15 mm, which allows for its connection to the tube.
endotracheal or to a connection at the elbow,
External diameter of 22 mm, to connect to a face mask if it is
necessary.
In modern anesthesia machines, the sampling for the
monitorizaciońde los gasesestálocalizada en laconexión en Y,
What allows gases to be studied both in inspiration and in
breathing.
The anatomical dead space of the circular system begins at the Y piece.

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Mapleson Circuits

These systems resemble the circular system in that they have a source of fresh gas,
they provide the amount of gas to the patient from a reservoir necessary to meet their flow and their
inspiratory volume, and to eliminate carbon dioxide. They differ from the circulatory system
because they have a bidirectional flow and do not use an absorbent. Therefore, these circuits
they depend on the appropriate flow of fresh gas to eliminate carbon dioxide.

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Mapleson Circuits

The Mapleson A has a spring valve.

located near the facial mask, and the flow of
A fresh gas enters from the opposite point of the circuit,
near the reservoir bag.

Spring-loaded valve located near the

facial mask, but the fresh gas inlet is
near the patient.
B and C Both the reservoir bag and the reservoir tube
they act as a blind arm in which they blend the
fresh gas, the gas from dead space and the alveolar.

Also known as the 'T-piece' group,

D, E and F the fresh gas enters near the patient, and the excess of
gases are eliminated through the opposite point of the circuit.

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+ Check of the anesthesia machine
Recommendations for Pre-Anesthesia Checkout Procedures from 2008 by ASA

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