- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04210570
Decreasing Environmental Impact and Costs of Using Inhalational Anesthetic With a Carbon Dioxide Membrane Filter System
Decreasing Environmental Impact and Costs of Using Inhalational Anesthetics by Replacing Chemical Absorbers With an Innovative Carbon Dioxide Membrane Filter System - a Prospective, Randomized, Clinical Trial
Efficient inhalational anesthetic delivery requires the use of low-flow air and oxygen to reduce drug waste and minimize workspace contamination and environmental pollution. Currently, excess anesthetic gas is scavenged and removed from the operating room via the hospital ventilation system, where it is released into the atmosphere. CO2 is removed from the anesthesia circuit by the use of CO2 removal systems to prevent re-breathing and potential hypercarbia.
Carbon dioxide is currently removed using chemical granulate absorbers (CGAs), which trap CO2 in the granules that are later disposed of when absorption capacity is reached. They require replacement approximately every other day when used in moderate to high volume surgical centres, placing a costly burden on the healthcare system and environment (landfill).
One of the more concerning downfalls of using CGAs is the potential for the inhalational anesthetics to react with the granules and potentially produce toxic byproducts known as compounds A-E that are nephrotoxic and neurotoxic and require excess amounts of anesthetic gas to dilute.
This excess use of anesthetics gases places a financial burden on the healthcare system and has a detrimental impact on the environment. The vast majority of the gases used are eventually released into the environment with little to no degradation where they accumulate in the troposphere and act as greenhouse gases.
DMF Medical has created Memsorb, a new CO2 filtration membrane. Memsorb can remove CO2 from the anesthesia circuit without the use of CGAs, thereby eliminating the potential for toxic byproducts and allowing for significantly lower air and oxygen flow to be used, resulting in less use of inhalational anesthetics. Memsorb uses a polymeric membrane (similar to the ones used in oxygenators for cardiac surgery) that selectively allows CO2 to leave the rebreathing system, while maintaining the inhalational anesthetic in the circuit.
The lifespan of Memsorb is at least 12 months, resulting in less particulate waste and a decreased cost to the healthcare system.
We wish to evaluate the ability and efficacy of Memsorb in removing CO2 from the anesthesia circuit while maintaining physiologic minute volume ventilation, as compared to the traditional CGAs in a variety of surgical procedures, patient populations, and anesthesia gas flows.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Ruediger Noppens, MD, PhD, FRCPC
- Phone Number: 35111 519) 685-8500
- Email: ruediger.noppens@lhsc.on.ca
Study Contact Backup
- Name: Lee-Anne Focesato
- Phone Number: 519 685-8500
- Email: LeeAnne.Fochesato@lhsc.on.ca
Study Locations
-
-
Ontario
-
London, Ontario, Canada, N6A 5A5
- Recruiting
- LHSC
-
Contact:
- Ruediger Noppens
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- ASA I - III
- Elective surgical procedure
- Laparoscopic surgery for study aim III
Exclusion Criteria:
- ASA > IV
- Emergency surgery
- Severe respiratory disease (eg Asthma)
- Raised intracranial pressure
- Regional anesthesia
- Absence of arterial line for study aim III
- Self-reported pregnancy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Memsorb GA
Memsorb Filter will be used during general anesthesia (GA), fresh gas flow and ventilator settings are not modified
|
Memsorb uses a polymeric membrane (similar to the ones used in oxygenators for cardiac surgery) that selectively allows CO2 to leave the rebreathing system while maintaining the inhalational anesthetic in the anesthesia circuit
|
Active Comparator: CGA GA
Chemical CO2 absorber (CGA) will be used during general anesthesia (GA), fresh gas flow and ventilator settings are not modified
|
Chemical granulate absorber trap CO2 chemically in granules that are later disposed of when absorption capacity is reached
|
Experimental: Memsorb low-flow
Memsorb Filter will be used during low flow general anesthesia (GA)
|
Memsorb uses a polymeric membrane (similar to the ones used in oxygenators for cardiac surgery) that selectively allows CO2 to leave the rebreathing system while maintaining the inhalational anesthetic in the anesthesia circuit
|
Experimental: CGA low flow
Chemical CO2 absorber (CGA) will be used during low flow general anesthesia (GA)
|
Chemical granulate absorber trap CO2 chemically in granules that are later disposed of when absorption capacity is reached
|
Experimental: Memsorb laparoscopic surgery
Memsorb Filter will be used during general anesthesia for laparoscopic surgery
|
Memsorb uses a polymeric membrane (similar to the ones used in oxygenators for cardiac surgery) that selectively allows CO2 to leave the rebreathing system while maintaining the inhalational anesthetic in the anesthesia circuit
|
Experimental: CGA laparoscopic surgery
Chemical CO2 absorber (CGA) will be used during laparoscopic surgery
|
Chemical granulate absorber trap CO2 chemically in granules that are later disposed of when absorption capacity is reached
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Effectiveness of Memsorb compared to CGA to eliminate CO2
Time Frame: Duration of general anesthesia (up to 12 hours)
|
etCO2 (mmHg) and tidal volumes (ml) will be measured with the two systems in GE / Dates Ohmeda anesthesia machines
|
Duration of general anesthesia (up to 12 hours)
|
Impact of Memsorb, using minimal flow anesthesia (≤ 0.50 L/min), on the amount of inhalational anesthetic (ml) used, compared to standard practice
Time Frame: Duration of general anesthesia (up to 12 hours)
|
Usage of Desflurane in ml will be measured during minimal flow (≤ 0.5 L/min) anesthesia, compared to traditional higher gas flow (> 2 L/min).
|
Duration of general anesthesia (up to 12 hours)
|
Effectiveness of using Memsorb during ventilation for removal of CO2 in laparoscopic surgeries resulting in high CO2 exposure, compared to CGAs
Time Frame: Duration of general anesthesia (up to 12 hours)
|
etCO2 (mmHg), paCO2 (mmHg) and tidal volumes (ml) needed remove CO2 during laparoscopic surgery, resulting in higher CO2 exposure.
|
Duration of general anesthesia (up to 12 hours)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Amount of inhaled anesthetics used
Time Frame: Duration of general anesthesia (up to 12 hours)
|
Usage on inhaled anesthetics in ml for the surgery.
|
Duration of general anesthesia (up to 12 hours)
|
Duration of anesthesia
Time Frame: Duration of general anesthesia (up to 12 hours)
|
Durantion measured in minutes
|
Duration of general anesthesia (up to 12 hours)
|
Water build up in anesthesia circuit
Time Frame: Duration of general anesthesia (up to 12 hours)
|
Likert scale to measure water build up (1- no water, 3 - large amount of water)
|
Duration of general anesthesia (up to 12 hours)
|
Freshgas flow during general anesthesia
Time Frame: Duration of general anesthesia (up to 12 hours)
|
Measured in ml/min
|
Duration of general anesthesia (up to 12 hours)
|
Number of CGAs used during the study period
Time Frame: Duration of general anesthesia (up to 12 hours)
|
absolute number of canisters used
|
Duration of general anesthesia (up to 12 hours)
|
Minute volume ventilation
Time Frame: Duration of general anesthesia (up to 12 hours)
|
tidal volume (ml) x respiratory rate (/min)
|
Duration of general anesthesia (up to 12 hours)
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 114511
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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