Carbon monoxide can be generated as a by-product of anesthesia, so anesthesiologists use specific precautions to limit its production, according to the release. Richard J Levy, MD, chief of cardiac anesthesiology at Children’s National, led the studies, and his team identified two conditions under which children may inhale carbon monoxide during anesthesia:
- Carbon monoxide as detected in the breathing circuit correlated with the increase in blood levels in children 2 years and older.
- The patient’s own exhaled carbon monoxide may be “re-breathed” during low-flow anesthesia — the current standard of care, according to the release — where fresh gas flows more slowly into the circuit, rather than rapidly.
The effects of low-dose carbon monoxide exposure on the developing brain are unknown, but some recent studies have suggested a link between exposure and hearing impairments, according to the release.
“The main goal is to provide the safest environment for young patients who require surgery,” Dr. Levy said in the release. “We have identified tangible ways to reduce the risk of carbon monoxide exposure, and our hope is that these changes will be implemented internationally.”
Two of Dr. Levy’s suggestions to reduce carbon monoxide exposure are:
- Use carbon dioxide absorbents that lack strong metal alkali in the anesthesia machine and do not degrade inhaled anesthetics to avoid carbon monoxide production risk.
- Avoid of low-flow anesthesia to avoid carbon monoxide re-breathing risk.
Following the study’s findings, Children’s National switched to the recommended absorbent to minimize the risk to patients.
Read the release on carbon monoxide exposure in children during anesthesia.
