Title
A novel cause of rebreathing carbon dioxide related to removed CLIC-seal on the Dräger Apollo© anesthesia machine
Publication Date
2018
Journal Title
J Clin Monit Comput
Abstract
© 2018 Springer Science+Business Media B.V., part of Springer Nature We present a case report involving two sequential, surgically uneventful, laparoscopic cholecystectomies using the same anesthesia machine (Drager Apollo©) for which the level of inspired carbon dioxide was noted to be elevated following various diagnostic interventions including replacing the sodalime, increasing fresh gas flows, and a full inspection of equipment for malfunction. Eventually it was discovered that a rubber ring seal connecting the Dragersorb CLIC system© to the sodalime canister was inadvertently removed during the initial canister exchange resulting in an apparent bypassing of the absorbent and thus an inability of the exhaled gas to contact the sodalime. To our knowledge this is the first such description of this potential cause of elevated inspired carbon dioxide and should warrant consideration when other conventional interventions have failed.
Document Type
Article
Status
Faculty; Northwell Resident
Facility
School of Medicine; Northwell Health
Primary Department
Anesthesiology
PMID
DOI
10.1007/s10877-018-0161-0