AMSORB® PLUS
From the manufacturers of the world’s first strong
alkali-free absorbent, AMSORB®, now comes
AMSORB® PLUS...
AMSORB® PLUS is a new generation carbon dioxide absorbent, free from strong alkali metal hydroxides. It utilises calcium hydroxide (Ca(OH)2) as the active base with minor constituents that promote speed and capacity of absorption.
AMSORB® PLUS is specifically designed for low and minimal flow anaesthesia. Its absorption capacity, intensity and uniformity of colour change have been improved from the original AMSORB®.
The chemical composition remains unaltered but the manufacturing process has been carefully developed to deliver enhanced absorption capacity. AMSORB® PLUS remains the world’s only carbon dioxide absorbent capable of complete prevention of anaesthetic degradation. AMSORB® PLUS is the safest absorbent available.
Many conventional soda limes, and even some new generation absorbents, claim suitability for safe low flow anaesthesia. However, many of these still contain sodium hydroxide (NaOH) and some potassium hydroxide (KOH).
Research1 has shown that the presence of sodium hydroxide, at any level, provides the basis for anaesthetic agent dehalogenation.
AMSORB® PLUS is the only absorbent to ensure that gas delivery is free from potentially toxic chemicals.
Excellence in Patient Safety
Free from Strong Alkali
AMSORB® PLUS does not contain sodium hydroxide, potassium hydroxide or barium hydroxide (Ba(OH)28H2O)
Unreactive with Modern Anaesthetic Drugs
AMSORB® PLUS does not degrade volatile anaesthetic agents
Eliminates Production of Toxic Byproducts
AMSORB® PLUS does not generate carbon monoxide under any clinical conditions
AMSORB® PLUS does not generate Compound A, or any similar compounds, when used with sevoflurane
AMSORB® PLUS does not generate formaldehyde when used with sevoflurane
Optimum Carbon Dioxide Absorption Capacity
Unique Granule Properties
AMSORB® PLUS granules are manufactured from 2.5mmØ extrudate which is then dried, sieved and rewet to a critical moisture content. The mixing and extrusion processes ensure complete homogeneity of the chemicals.
Absorption capacity is further optimised by granule porosity resulting from typical surface area of 19.61m2/g compared to 4.5m2/g with other available absorbents.
Under normal conditions the granules will not break down in the high humidity gas stream. The addition of calcium sulphate ensures that they are able to exchange moisture for carbon dioxide without causing the granule to disintegrate or absorb exothermic moisture.
Ideal Bed Packing
AMSORB® PLUS offers excellent bed packing and provides high bulk density (>80%), without creating obstruction to gas flow. Intragranular spaces formed by longer granules are filled with shorter granules.
Optimal Canister Design
Research has proven that the absorptive capacity of any carbon dioxide absorbent is highly dependent on the design and size of the canister3,4. Absorption capacity with AMSORB® PLUS and other carbon dioxide absorbents will be reduced when small volume absorber canisters are used
Ideally, the canister volume should be >1.5L volume, in which case it will hold approximately 1.2kg of absorbent. In this case, the intragranular space will be sufficient to accommodate the patients tidal volume and, therefore, optimise absorption.
High Performance Cartridge
The high performance AMSORB® PLUS cartridge eliminates gas channelling and poor colour change which are associated with conventional soda lime cartridges.
The cartridge has been designed to provide a constant gas flow throughout the cartridge which creates circumferential colour change by utilising all the granules.
A unique design on the base of the cartridge creates resistance to downward flow and re-circulates gas upwards along the circumference before the venturi effect from the down flow allows the gas to exit through the base.
To eliminate carbon dioxide bypassing the cartridge there is a foam seal surrounding the circumference of the absorber tray.
Conventional Soda Lime Granules
AMSORB® PLUS Granules
AMSORB® PLUS Unique Granules x950
Reliable Granule Exhaustion Indication
Irreversible Colour Change
AMSORB® PLUS does not contain strong alkali and, therefore, preserves its colour change once exhausted; unlike conventional carbon dioxide absorbents which, once exhausted, revert to their original colour
Safe Operating Room Environment
Minimal Dust Contamination
AMSORB® PLUS state-of-the-art manufacturing facilities ensure dust formation is to a minimum
AMSORB® PLUS has been tested in conformance with relevant parts of USP
AMSORB® PLUS granules do not disintegrate under normal transit and handling conditions
Non-Corrosive to Skin
AMSORB® PLUS, unlike soda limes, is labelled as an irritant rather than being corrosive to skin. It is safe for anaesthesia staff to handle without special precautions
Convenient and Efficient Packaging
Pre-filled Disposable Cartridge
AMSORB® PLUS is available in a pre-filled disposable 1kg cartridge which is fitted with a tamper-proof lid and individually sealed in air-tight wrapping (to be removed)
The cartridge is intended for use in anaesthetic machines with 2-compartment absorber trays. The unit works efficiently for gas flow in the direction of top-tobottom and bottom-to-top
Jerican
AMSORB® PLUS is also available in a 4.5kg jerican with wide neck and tamper-proof resealable cap
1Stabernack C R et al. Absorbents Differ Enormously in Their Capacity to Produce Compound A and Carbon Monoxide. Anesth. Analg. 2000; vol. 90; pp 1428 - 1435
2Kharasch E D. Putting the Brakes on Anesthetic Breakdown. Anesthesiology 1999; vol. 91; pp 1192 - 1194
3Bedi A et al. The in vitro performance of carbon dioxide absorbents with and without strong alkali. Anaesthesia 2001; vol. 56; pp 1 - 6
4Ueyama H et al. LETTER. Warning: Carbon Dioxide Absorption Capacity of Amsorb Was Unexpectedly Low in Low-Flow Anesthesia. Anesthesiology 2000; vol. 93; pp 1560. In reply: Murray JM et al. Anesthesiology 2000; vol. 93; pp 1561
5Ebert T J et al. A New Carbon Dioxide Absorbent Devoid of Anesthetic Breakdown. Anesthesiology, Medical College of Wisconsin and VA Medical Center, Milwaukee, WI USA
6Higuchi H et al. Compound A Concentrations During Low-Flow Sevoflurane Anesthesia Correlate Directly with the Concentration of Monovalent Bases in Carbon Dioxide Absorbents. Anesth. Analg. 2000; vol. 91; pp 434 - 439
7Murray J M et al. Amsorb A New Carbon Dioxide Absorbent for Use in Anesthetic Breathing Systems. Anesthesiology 1999; vol. 91; pp 1342 - 1348
8Yamakage M et al. Carbon Dioxide Absorbents Containing Potassium Hydroxide Produce Much Larger Concentrations of Compound A from Sevoflurane in Clinical Practice. Anesth. Analg. 2000; vol. 91; pp 220 - 224
9United States Environmental Protection Agency - Formaldehyde
10Funk W et al. Dry soda lime markedly degrades sevoflurane during simulated inhalation induction. Br. J. of Anaesth. 1999; vol. 82; pp 193 - 198
11Bedi A et al. The In Vitro Degradation of Sevoflurane to Formaldehyde Following Exposure to CO2 Absorbents. Anesthesiology 2001; vol. 95; A1190. Abstract from ASA 2001, New Orleans
12Bedi A et al. LETTER. Postoperative nausea and vomiting following 8% sevoflurane anaesthesia. Anaesthesia 2000; vol. 55; pp 594 - 595
14Baum J et al. Calcium hydroxide lime - a new carbon dioxide absorbent: a rationale for judicious use of different absorbents. European Jn. of Anesthesiology 2000; vol. 17; pp 597 - 600
15Kharasch E D et al. Comparison of AMSORB®, Sodalime, and Baralyme® Degradation of Volatile Anesthetics and Formation of Carbon Monoxide and Compound A in Swine In Vivo. Anesthesiology 2002; vol. 96; pp 173 - 182
16Lentz R E. CO poisoning during anesthesia poses puzzle. Jn. Clin. Monit 1995; vol. 11; pp 67 - 71
17Berry P D et al. Severe Carbon Monoxide Poisoning during Desflurane Anesthesia. Anesthesiology 1992: vol. 90; pp 613 - 616
18D’Eramo C D. AMSORB®: safety and absorptive capacity during low-flow anaesthesia. Preliminary clinical experience. Universitá di Parma 2001