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  • Title: Bymixer system can measure O2 uptake and CO2 elimination in the anesthesia circle circuit.
    Author: Rosenbaum A, Kirby CW, Breen PH.
    Journal: Can J Anaesth; 2007 Jun; 54(6):430-40. PubMed ID: 17541071.
    Abstract:
    BACKGROUND: The ability to measure carbon dioxide elimination (Vco(2)), oxygen uptake (Vo(2)), and R (respiratory exchange ratio, Vco(2)/Vo(2)) during anesthesia may help the non-invasive detection of critical events (e.g., abrupt decrease in cardiac output) and metabolic upset (e.g., onset of anaerobic metabolism). METHODS: We have developed a new clinical bymixer (inline mixing chamber) that can measure mixed inspired and expired gas fractions in the anesthesia circle circuit. The addition of a standard anesthesia gas analyzer and flowmeter, and a new airway temperature and humidity sensor, allow determinations of Vco(2) and Vo(2) at the airway opening of the circle circuit. Over a range of tidal volume and frequency, Vco(2) and Vo(2) were compared to reference values generated by the combustion of metered liquid ethanol in a new metabolic lung simulator. RESULTS: By linear regression, bymixer-flow measurements of Vco(2) (slope = 1.02, Y-intercept = -5.31, coefficient of determination, R(2) = 0.998) and Vo(2) (slope = 1.05, Y-intercept = -4.34, R(2) = 0.993) correlated closely to the reference values generated by the metabolic lung simulator. Limits of agreement analysis generated percent errors (mean +/- 1.96 SD) of -1.2 +/- 7.2% for Vco(2) and 2.5 +/- 9.8% for Vo(2). CONCLUSIONS: The new clinical bymixer is compact, lightweight, disposable, inexpensive, and has a fast and adjustable response time (time constant about 14 sec). Anesthesia circle circuit integrity is maintained. Bymixer-flow measurements of Vco(2) and Vo(2) are accurate and may add to clinical monitoring under anesthesia and surgery.
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