Why new delivery systems?

Although anesthetists have accomplished a remarkable safety record with commercially available anesthetic machines, these results have been obtained in spite of machine design, which could best be described as a nonsystem. In cases involving severely compromised patients, surgical procedures that severely alter patient physiology, and untoward events during "routine" anesthesia, it is a tribute to the flexibility and resourcefulness of anesthetists that more incidents do not occur. Industry has long sought precision, reliability, automatic control, and human-factors engineering in nonmedical applications, such as aircraft cockpit design, word-processing stations, and manufacturing processes. The relentless accretion of more and more nonintegrated gadgets onto an antiquated technology has exceeded the boundaries of proper function. Neither the patient nor the anesthetist is being served well by failure to implement state-of-the-art technology in anesthesic delivery systems. Anesthesiologists and others who are vitally interested in the welfare of their patients must insist that development of radically new integrated modular systems proceed at full speed. Their checkbooks can speak as loudly as the facts; it is time the manufacturers are aware that deep concern will be translated into purchasing decisions.