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Precise Control of End-tidal Carbon Dioxide Levels Using Sequential Rebreathing Circuits

Title: Precise Control of End-tidal Carbon Dioxide Levels Using Sequential Rebreathing Circuits
Authors: Somogyi, R. B.; Vesely, A. E.; Preiss, D.; Prisman, E.; Volgyesi, G.; Azami, T.; Iscoe, S.; Fisher, J. A.; Sasano, H.
Source: Anaesthesia and Intensive Care ; volume 33, issue 6, page 726-732 ; ISSN 0310-057X 1448-0271
Publisher Information: SAGE Publications
Publication Year: 2005
Description: Anaesthesiologists have traditionally been consulted to help design breathing circuits to attain and maintain target end-tidal carbon dioxide (P ET CO 2 ). The methodology has recently been simplified by breathing circuits that sequentially deliver fresh gas (not containing carbon dioxide (CO 2 )) and reserve gas (containing CO 2 ). Our aim was to determine the roles of fresh gas flow, reserve gas PCO 2 and minute ventilation in the determination of P ET CO 2 . We first used a computer model of a non-rebreathing sequential breathing circuit to determine these relationships. We then tested our model by monitoring P ET CO 2 in human volunteers who increased their minute ventilation from resting to five times resting levels. The optimal settings to maintain P ET CO 2 independently of minute ventilation are 1) fresh gas flow equal to minute ventilation minus anatomical deadspace ventilation, and 2) reserve gas PCO 2 equal to alveolar PCO 2 . We provide an equation to assist in identifying gas settings to attain a target PCO 2 . The ability to precisely attain and maintain a target PCO 2 (isocapnia) using a sequential gas delivery circuit has multiple therapeutic and scientific applications.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1177/0310057x0503300604
DOI: 10.1177/0310057X0503300604
Availability: https://doi.org/10.1177/0310057x0503300604; https://journals.sagepub.com/doi/pdf/10.1177/0310057X0503300604
Rights: https://journals.sagepub.com/page/policies/text-and-data-mining-license
Accession Number: edsbas.DBB69932
Database: BASE