The Anesthesia Machine: Managing Exhaled and Waste Gases

Effective and safe CO2 absorption is critical to the anesthesia circle system to prevent rebreathing and hypercapnia. Advances in the original soda lime–based absorbents and their container systems continue to improve patient safety, reducing the risk of compound A and carbon monoxide production, with seemingly little compromise to the efficiency of CO2 absorption capabilities. Scavenging systems and the removal of waste anesthesia gases remain a critical component to anesthesia care, and vigilance to maintain approved systems is a key to operating room staff safety. Advances in anesthesia machine design have resulted in more complicated internal breathing circuits that are increasingly difficult to rid of trace anesthetic gases. This inadvertently led to a necessary change in guidelines on anesthesia machine preparation for patients susceptible to malignant hyperthermia (MH).   This review contains 5 figures, 6 tables, and 59 references. Keywords: carbon dioxide absorption, carbon monoxide, CO2 absorption, compound A, malignant hyperthermia machine preparation, operating room safety, scavenging systems, waste anesthesia gases