Blutalkohol 2005 - BADS (Bund gegen Alkohol und Drogen im ...

422
Breitmeier/Besch/Gebel/Panning,
Measuring of end-expired breath ethanol concentration following percutaneous ethanol injections
(PEI) carried out on patients suffering from hepatocellular Carcinoma
of alcohol measurements in main or secondary flow procedures with the use of two different
devices will be discussed. In addition alcohol levels in breath will be contrasted with
venous and arterial blood alcohol levels.
Material and Methods
Of the altogether 43 patients where PEI was executed during general anesthesia, venous
and arterial blood samples were taken parallel to the measuring of the breath ethanol concentration
(BrAC) to determine blood alcohol concentration (BAC). This procedure was
authorised by the ethics commission for the entire process of the percutaneous ethanol
injection by patients with hepatocellular carcinoma especially for taking venous and arteriell
blood samples parallel to the breath ethanol measuring.
Individual measurings were taken before, during and after injection of alcohol into the
tumor. The number of measurings per patient depended on the length of therapy or the
respective injected amounts of alcohol. When the patient was informed about the anesthesia
to be performed information about breath and blood alcohol monitoring during
therapy was included. Patients got a venous as well as an arterial catheter. With 19 patients
(59 BrAC measurings) breath alcohol concentration was tested in secondary flow using the
Alcomed 3011 of Envitec Wismar (Envitec Group); 24 patients (47 BrAC measurings)
were tested in the main flow using the Alcotest 7410 med of Dräger (Dräger Group).
Determination of alcohol concentration in arterial and venous bloodsamples was made
according to generally accepted forensic standards using the ADH-method as well as gaschromatography.
Alcomed 3011, Envitec Wismar: The device was employed in the passive mode with intubated
patients. An adapter with a lateral Luer-Lock ® connector was inserted between the
endotracheal tube and the airway filter. The device was connected with the Luer-Lock
adapter using a plastic tube provided by the manufacturer. Respective measuring was started
by the researcher. After being activated the device sucked in a gas sample after a latency
period of about 1,7 seconds (manufacturer’s data) through the suction tube and directed
it to the sensor. Therefore measuring was activated 2 seconds before the lowest point of
expiration so that it can be safely said that the gas sample consisted of end-expired breath
(Fig 1).
-Inspiration- -------Expiration-------------------Inspiration--
0 1 2 3 4 5 6 7 8
BLUTALKOHOL VOL. 42/2005
Extraction of the gasprobe
Trigger of the measuring (Alcomed 3011)
Figure 1: Trigger time for measuring of the breath alcohol concentration with the Alcomed 3011 in the passive
mode (modified by the instructions of the manufacturer). In the hatched area the gasprobe consist of endexpired
breath in the expiration phase.