• B Niknam, Z Bebic, and A Roseman.
• Department of Anesthesiology at Long Island Jewish Medical Center, Hofstra-Northwell School of Medicine, 270-05 76th Avenue Room B-341, New Hyde Park, Long Island, NY, USA. Benjamin.niknam@gmail.com.
• J Clin Monit Comput. 2019 Apr 1; 33 (2): 349-351.

AbstractWe present a case report involving two sequential, surgically uneventful, laparoscopic cholecystectomies using the same anesthesia machine (Drager Apollo©) for which the level of inspired carbon dioxide was noted to be elevated following various diagnostic interventions including replacing the sodalime, increasing fresh gas flows, and a full inspection of equipment for malfunction. Eventually it was discovered that a rubber ring seal connecting the Dragersorb CLIC system© to the sodalime canister was inadvertently removed during the initial canister exchange resulting in an apparent bypassing of the absorbent and thus an inability of the exhaled gas to contact the sodalime. To our knowledge this is the first such description of this potential cause of elevated inspired carbon dioxide and should warrant consideration when other conventional interventions have failed.

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