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Asynchrony Between Ventilator Flow and Pressure Waveforms and the Capnograph on Dräger Anesthesia Workstations: A
Mukesh Tripathi1, Nilay Tripathi, Mamta Pandey
1From the *Department of Anesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; †Ursila District Hospital, Kanpur; ‡Emergency Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Abstract:
Modern anesthesia workstations display capnography, flow-time, and pressure-time waveforms in real time. We observed that at certain ventilator settings (10 breaths/min) on Dräger workstations, the expiratory phase of the capnograph overlaps both the inspiratory and the expiratory phases of ventilation. This discrepancy disappears at respiratory rates of 16 breaths/min. This synchronous respiratory monitoring display at respiratory rates 16 breaths/min is not physiologically correct, because it implies a synchronization of waveforms that is not actually present. This again becomes asynchronous once the respiratory rate is increased to >18 breaths/min. Such an artifact may not affect the patient's safety in most cases but may mislead clinicians when synchrony between flow/pressure and capnography is needed for diagnostic purposes. We wish to share this discrepancy with clinicians and notify the manufacturer so that potential solutions may be found.
