Performance of an electrochemical carbon monoxide monitor in the presence of anesthetic gases.

Abstract

The passage of volatile anesthetic agents through accidentally dried CO2 absorbents in anesthesia circuits can result in the chemical breakdown of anesthetics with production of greater than 10000 ppm carbon monoxide (CO). This study was designed to evaluate a portable CO monitor in the presence of volatile anesthetic agents. Two portable CO monitors employing electrochemical sensors were tested to determine the effects of anesthetic agents, gas sample flow rates, and high CO concentrations on their electrochemical sensor. The portable CO monitors were exposed to gas mixtures of 0 to 500 ppm CO in either 70% nitrous oxide, 1 MAC concentrations of contemporary volatile anesthetics, or reacted isoflurane or desflurane (containing CO and CHF3) in oxygen. The CO measurements from the electrochemical sensors were compared to simultaneously obtained samples measured by gas chromatography (GC). Data were analyzed by linear regression. Overall correlation between the portable CO monitors and the GC resulted in an r2 value >0.98 for all anesthetic agents. Sequestered samples produced an exponential decay of measured CO with time, whereas stable measurements were maintained during continuous flow across the sensor. Increasing flow rates resulted in higher CO readings. Exposing the CO sensor to 3000 and 19000 ppm CO resulted in maximum reported concentrations of approximately 1250 ppm, with a prolonged recovery. Decrease in measured concentration of the sequestered samples suggests destruction of the sample by the sensor, whereas a diffusion limitation is suggested by the dependency of measured value upon flow. Any value over 500 ppm must be assumed to represent dangerous concentrations of CO because of the non-linear response of these monitors at very high CO concentrations. These portable electrochemical CO monitors are adequate to measure CO concentrations up to 500 ppm in the presence of typical clinical concentrations of anesthetics.