GE CARESCAPE - Prevention of the breathing system contamination; How to prevent effects of humidity; Oxygen delivery, CARESCAPE respiratory modules and compact airwa

Airwaygases
IncreasedEtCO
2
concentration(EtCO
2
>6.0%/45mmHg)indicateshypoventilationor
ineffectivealveolarventilation,whichwillleadtohypercapniaandrespiratoryacidosis.
IncreasedinspiratoryCO
2
(FiCO
2
)concentrationsmayalsobecausedby:
●ExhaustedCO
2
absorber.
●Malfunctionofthebreathingsystemvalves.
●RebreathingwhenarebreathingsystemwithoutaCO
2
absorberisusedwith
inadequatefreshgasows.
NOTE
Duringsomesurgicalprocedures,e.g.laparoscopy,CO
2
may
beusedtoinatetheabdomenwhichmayresultinriseof
PaCO
2
duetotheabsorptionofCO
2
intothebloodviathe
vascularwoundbed.Thismayleadtoanincreaseinthe
EtCO
2
.
Preventionofthebreathingsystemcontamination
Youcanuseamicrobiallterbetweentheendotrachealtubeandtheairwayadapter.
Changethelterforeverypatient.Changethepatientcircuitatintervalsgiveninthe
circuitmanufacturer’sdocumentation,andaccordingtoyourhospitalprotocols.
Howtopreventeffectsofhumidity
Inanesthesia,thelowerthefreshgasow,themorerebreathedgasrecirculates
throughtheCO
2
absorberandthemorehumidityandheatisproducedthroughthe
chemicalCO
2
absorptionprocess.
●Ifamoistureexchangerisused,placeitbetweentheendotrachealorintubation
tubeandtheairwayadapter.Inintensivecare,themoistureexchangermustbe
replacedatleastevery24hours.
●Placeallairwayadapterportsupwardswitha20°to45°tilttopreventcondensed
waterfromenteringthesensorinteriorandthetubings.
●Theairwayadaptershouldbeemptiedofclearlyvisiblewaterdroplets,orreplaced
withadryandcleanadapter.
●Ifactivehumidicationisused,extrawatercollectorsmaybeplacedbetweenthe
ventilator’sinspiratoryandexpiratorybreathingtubings.Theyarealsousefulfor
condensedwatercollectionduringlong-lastinganesthesia.
Oxygendelivery,CARESCAPErespiratorymodulesand
compactairwaymodules
Oxygenuptakeandconsumption
Oxygenconsumptionisthedifferencebetweentheamountofoxygendeliveredto
thetissuesbythearterialcirculationandtheamountofoxygenreturnedtotheheart
bythevenoussystem.Theformulaforoxygenconsumptionisasimplerestatement
oftheFickequation,whichidentiesallofthepertinentvariablesofoxygensupply
anddemand.VO
2
=COxHbx13.8x(SaO
2
-SvO
2
).Dependentfromthepatient’s
circulationstatusthemechanicalventilatorsettingsfor,amongstothers,FiO
2
inthe
deliveredgasmix(min.>25%)shouldguaranteeasufcientPAO
2
andPaO
2
.Patients
withfevermayconsumeoxygenatconsiderablyhigherrates.
Oxygensupplytothebreathingsystemmustmeetthemetabolicneedofthepatient.
304CARESCAPEModularMonitors2062971-001