Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2019
Letter Case ReportsA novel cause of rebreathing carbon dioxide related to removed CLIC-seal on the Dräger Apollo© anesthesia machine.
We 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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J Clin Monit Comput · Apr 2019
Comment LetterResponse to: Is the new ASNM intraoperative neuromonitoring supervision "guideline" a trustworthy guideline? A commentary.
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J Clin Monit Comput · Apr 2019
Comment LetterIn response: "A novel cause of rebreathing carbon dioxide related to removed CLIC-seal on the Dräger Apollo© Anesthesia Machine" from B. Nikman et al. in this issue of JCMC.
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J Clin Monit Comput · Apr 2019
Comment LetterIn response: Blood CO2 exchange monitoring, Haldane effect and other calculations in sepsis and critical illness.
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Clinical monitoring and technology are at the heart of anesthesiology, and new technological developments will help to define how anesthesiology will evolve as a profession. Anesthesia related research published in the JCMC in 2018 mainly pertained to ICU sedation with inhaled agents, anesthesia workstation technology, and monitoring of different aspects of depth of anesthesia.