Improved response time with a new miniaturised main-stream multigas monitor
For paediatric monitoring and demanding applications such as metabolic monitoring and measurements of functional residual capacity combining gas concentration with flow/volume measurements the performance of side-stream monitors (SSGM) is suboptimal. The objective was to evaluate the performance of a miniaturised mainstream multigas monitor (MSGM) alleged to offer fast response gas monitoring. The MSGM uses infrared technique for measurements of carbon dioxide, nitrous oxide and inhalation agents and fuel cell technique for oxygen monitoring. The MSGM performance was com- pared to a state of the art side-stream monitor in a bench study.
Response time was measured in two bench study set ups; a high flow oxygen flush to achieve one step change in gas concentrations and during continuous ventilation using a circuit with an oxygen consuming/carbon dioxide producing lung model connected to a ventilator. Averaged tracings from the tested monitors were used for calculation of the 90–10% decline of CO2, the corresponding 10–90% incline of O2 and N2O and of Isoflurane concentrations in the flush set up and at different inspired O2 for the O2 upslope and corresponding CO2 down- slope during continuous ventilation at different breathing frequencies. Calibration gases with different concentrations of CO2, O2 and N2O were used for testing of accuracy.
The MSGM response time for CO2 was 96 (88–100) compared to 348 (340–352) ms for the SSGM (P < 0.001). Corresponding response times for O2 was 108 (76–144), and 432 (360–448) ms (P < 0.001), respectively. At a respiratory rate of 60 BPM the SSGM trace was damped and sinusoidal whereas the MSGM displayed wider amplitude and a square waveform. The deviations from calibration gas values were within clinically acceptable range and linear for all gases over the concentration range studied for both monitors.
The MSGM response time for CO2 and O2 was less than 1/3 of the SSGM. The performance of the MSGM was maintained at high breathing frequencies. The accuracy was within clinically acceptable limits for both monitors.
Keywordsanaesthetic gas monitoring mainstream sidestream
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Institutional funds and Research grants from The Sahlgrenska Academy, Gothenburg University supported the study.
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