The D-fend is present in front of Datex-Ohmeda capnographs. The potential technical sites causing an erroneous ETCO 2 value were analyzed as (1) external sampling tube (2) D-fend and (3) capnometer module. There was no sweating and heart rate returned to baseline value. The repeat Arterial blood gas analysis displayed pH 7.40, PaCO 2 34.3 mmHg, partial pressure of oxygen 128 mmHg, HCO 3 23.7 mM. As PaCO 2 was 56 mmHg, we increased the tidal volume to 550 mL and respiratory rate to 16/min. A gradient between PaCO 2 and ETCO 2 of 39 seemed inappropriate. Arterial blood gas analysis revealed pH 7.22, partial pressure of carbon dioxide (PaCO 2) 56 mmHg, partial pressure of oxygen 117 mmHg, bicarbonate 23.4 mM. Few minutes later, the patient had profuse sweating and tachycardia. The tidal volume was reduced to 450 mL and respiratory rate to 12, but these changes in ventilatory parameters failed to correct the ETCO 2. The anesthesiologist noticed an initial end tidal carbon dioxide (ETCO 2) of 17 mmHg on the patient monitor ( Figure 1). The ventilatory parameters in the workstation (GE Datex Ohmeda, Avance CS2’, Wipro GE Healthcare Pvt Ltd., Kolkota, West Bengal, India) were tidal volume of 500 mL, respiratory rate of 14/min, inspiratory to expiratory ratio of 1:2, and fractional inspired oxygen of 50%. After uneventful induction, the patient was intubated and put-on mechanical ventilation. The pre-induction vitals were blood pressure 144/96 mmHg, heart rate 88 beats per minute. Like the flight data recorder, the anesthesia workstation records important information which can be analyzed later to find out the technical fault to ensure further patient safety.Ī 38-year-old male patient was planned for clipping of middle cerebral artery aneurysm under general anesthesia. 1 Anesthesia is like flying an aircraft, and most mishaps are during takeoff and landing. Over the years there are many monitoring devices evolved for patient safety but malfunctioning of such devices gives a false sense of security and may adversely affect patient safety. We often fail to understand the technical complexity and related malfunction of newer sophisticated anesthesia workstations when encountered.
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