Fractional distillation of acid contaminants from sevoflurane.

On two occasions, sevoflurane distributed for clinical practice has been found to be contaminated with compounds thought to include hydrogen fluoride (HF) and silicon tetrafluoride (SiF(4)). Both compounds can produce pulmonary injury. However, injury would require fractional distillation of the compounds during the course of sevoflurane vaporization. We hypothesized that such distillation would occur and that the compounds would vaporize more rapidly than would sevoflurane. Thus, we tested whether fractional distillation occurs during vaporization of sevoflurane containing HF or SiF(4), or from sevoflurane containing HF converted to other compounds by contact with glass. Vaporization of < 10% of the sevoflurane distilled 65%-99% of these compounds, SiF(4) distilling most rapidly, HF (converted to other acidic compounds, including SiF(4)) distilling nearly as rapidly, and HF slowest. Nuclear magnetic resonance studies indicated that HF interaction with glass changed all HF to three other compounds, one being SiF(4) and the others being unknown. HF and SiF4 distill from sevoflurane more rapidly than sevoflurane is vaporized. Measurement of acidity after sevoflurane administration may not reveal a previous presence of such contaminants.