IMPROVED RESPONSE TIME WITH A NEW MINIATURISED MAIN-STREAM MULTIGAS MONITOR

Background. 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 compared to a state of the art side-stream monitor in a bench study. Methods. 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 CO(2), the corresponding 10-90% incline of O(2) and N(2)O and of Isoflurane concentrations in the flush set up and at different inspired O(2) for the O(2) upslope and corresponding CO(2) down-slope during continuous ventilation at different breathing frequencies. Calibration gases with different concentrations of CO(2), O(2) and N(2)O were used for testing of accuracy. Results. The MSGM response time for CO(2) was 96 (88-100) compared to 348 (340-352) ms for the SSGM (P<0.001). Corresponding response times for O(2) 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. Conclusions. The MSGM response time for CO(2) and O(2) 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.