1. The world’s first strong-alkali free absorbent
AMSORB® PLUS
The world’s first strong-alkali free absorbent

2. Free from Sodium, Potassium, Lithium and Barium Hydroxide
AMSORB® PLUS
Free from Sodium, Potassium, Lithium and Barium Hydroxide

3. The world’s first strong-alkali free absorbent
AMSORB® PLUS
The world’s first strong-alkali free absorbent

4. Chemical Formulations & Performance
Composition of Absorbents
AMSORB® PLUS Brochure Page 06
Chemical Formulations & Performance
AMSORB® PLUS is not a soda lime since it does not contain sodium hydroxide (NaOH).
None of the risks associated with soda limes apply to AMSORB® PLUS.
Leading brands of soda lime all contain NaOH.

5. The significance of NaOH within a C02 absorbent
Alkalinity of Soda Lime
AMSORB® PLUS Brochure Page 10
The significance of NaOH within a C02 absorbent
As the moisture content decreases, concentration of NaOH increases.
At 5% moisture, soda lime causticity causes agent degradation.
Desiccated soda limes are treated as hazardous waste.
Desiccated soda limes are unsafe to handle.
4.1%
3.5%
16%
5% Moisture 0%

6. AMSORB® PLUS contains 0% NaOH

7. Colour Change Soda lime colour change is not a reliable indicator.
AMSORB® PLUS Brochure Page 04
Colour Change
Soda lime colour change is not a reliable indicator.
Colour change in soda lime is based on alkalinity (pH).
Coloration in soda lime reverts to original state when not used for a few hours.
To use soda lime safely, it is necessary to dispose of a % of useable product.
AMSORB® PLUS colour change is based on moisture content.

8. AMSORB® PLUS has a permanent colour change

9. Application / Clinical Realities
When do you change
Application / Clinical Realities
When do you change?
Change at
¼ colour change
Change at
½ colour change
Change at
¾ colour change

10. Scenario One – ¼ Colour Change
APSF - Six steps to safely use soda lime.
Turn off all gas flow when the machine is not in use.
Change absorbent regularly, Monday morning for instance.
Change absorbent whenever colour change indicates exhaustion.
Change all absorbent, not just 1 canister in a 2 canister system.
Change absorbent when uncertain of the state of hydration.
If compact canisters are used, consider changing them more often.
If these steps are followed the volume of absorbent used will increase significantly

11. Cost of safely using a soda lime
¼ Colour Change
Cost of safely using a soda lime
Analysis of Discarded Soda Lime; Economic & Practice Implications
Franklin V. Cobos II, M.D., Max T. Baker, Ph.D., John H. Tinker, M.D
Department of Anesthesiology, Nebraska Medical Center, Omaha, Nebraska
Usable absorption capacity remaining ranged from
14% to 73%, with an average of 45%

12. Scenario 2 – ½ Colour Change
Concerned about colour reversal
Concerned about harmful toxins
Wasting usable product

13. Scenario Three – ¾ Colour Change
Carbon Monoxide Production
AMSORB® PLUS Brochure Page 08
Scenario Three – ¾ Colour Change
Carbon monoxide (CO) is not measured or monitored during anesthesia.
The brand which produces CO at the lowest level is LoFloSorb – 525ppm.
The brand which produces CO at the highest level is Medisorb – 13,317ppm!

15. The significance of NaOH within a C02 absorbent
Alkalinity of Soda Lime
AMSORB® PLUS Brochure Page 10
The significance of NaOH within a C02 absorbent
As the moisture content decreases, concentration of NaOH increases.
At 5% moisture, soda lime causticity causes agent degradation.
Desiccated soda limes are treated as hazardous waste.
Desiccated soda limes are unsafe to handle.
4.1%
3.5%
16%
5% Moisture 0%

16. AMSORB® PLUS cannot produce CO

17. Formaldehyde AMSORB® PLUS is not a soda lime (NaOH).
Leading brands of soda lime all contain NaOH.
NaOH causes anaesthetic agent degradation which has three side effects. Production of:
Carbon Monoxide (CO)
Compound A
Formaldehyde
Formaldehyde (HCOH) is produced when passing sevoflurane through certain brands of desiccated absorbent.
Bedi A et al state “Sevoflurane is degraded to formaldehyde when passed through dry CO2 absorbents that contain strong alkali.
Point 1. None of the risks associated with soda limes apply to AMSORB® PLUS.
Point 2. Self explanatory
Point 3. Sodium hydroxide (NaOH) causes anaesthetic agent degradation which has three side effects; production of:
Carbon Monoxide (CO)
Compound A
Formaldehyde
Point 4. Formaldehyde (HCOH) is produced when passing sevoflurane through certain brands of desiccated absorbent. HCOH is a potent inhalation irritant and carcinogen and should never be administered to patients. Postoperative nausea and vomiting (PONV) is caused by HCOH inhalation.
Point 5. Bedi A et al state “Sevoflurane is degraded to formaldehyde when passed through dry CO2 absorbents that contain strong alkali.
Formaldehyde was not detected when sevoflurane was exposed to either fresh or dry Amsorb.

18. AMSORB® PLUS cannot produce HCOH

19. To Summarise - The significance of NaOH within a C02 absorbent
Alkalinity of Soda Lime
AMSORB® PLUS Brochure Page 10
To Summarise - The significance of NaOH within a C02 absorbent
As the moisture content decreases, concentration of NaOH increases.
At 5% moisture, soda lime causticity causes agent degradation.
Desiccated soda limes are treated as hazardous waste.
Desiccated soda limes are unsafe to handle.
4.1%
3.5%
16%
5% Moisture 0%

20. Agent Adsorption
AMSORB® PLUS Brochure Page 09
Agent Adsorption
Soda lime becomes more caustic as it dries out. A caustic soda lime has the ability to adsorb and break down the anaesthetic agent.
Waste of anaesthetic drug.
Implications for the hospital = increased drug costs.

21. The AMSORB® PLUS Approach
Change only when indicated by capnometry
Do NOT change until FiC02 exceeds 0.5%(5mmHg)
Colour change is a visual indicator
Efficient drug delivery
Less time to equilibration
Safe handling & disposal
Affordable Cartridge options for all Anaesthesia workstations

22. Safety with Savings Mannion et al, 2011
Cost Implications
Safety with Savings
Mannion et al, 2011
Cost implications of replacing soda lime with AMSORB® PLUS
Soda lime changed as per APSF guidelines.
AMSORB® PLUS was used until breakthrough.
58% more soda lime was used than AMSORB® PLUS

23. Costing you Less The AMSORB® PLUS Challenge
The Mannion study provides the basis for The AMSORB® PLUS Challenge
The demonstrates that replacing soda lime with AMSORB® PLUS can achieve:
 25.7% Annual Anaesthetic Gas Savings
Annual savings of $272,818 per hospital with 50 operating rooms
$7.96 savings per patient
58% less absorbent used
A six–fold reduction in absorbent disposal costs
What can AMSORB® PLUS do for your facility?

24. Take the AMSORB® PLUS Challenge
Safety
No risk to patient or end user
Efficiency
Excellent C02 Absorption
Use less Anaesthetic Drug
Lower gas flow
Environmental
Safe for Waste Disposal
Non toxic
Safe for land fill

25. Summary
What have we learned?
 AMSORB® PLUS is the safest C02 absorbent available, it’s not capable of anaesthetic degradation
70+ independent clinical publications
Soda lime causticity increases as it’s moisture decreases (C02 absorption)
AMSORB® PLUS has a Permanent colour change – Soda lime will colour revert
How do I tell when my Soda lime becomes unsafe to use???
Adsorption – Soda lime is a subtle thief
Safety with $avings – Compromise no longer!

26. Contact Us