18 - 1
18 Monitoring Carbon Dioxide (CO
2
)
18.1 CO
2
 Introduction
CO
2
 monitoring is a continuous, non-invasive technique for determining the concentration of CO
2
 in the 
patient’s airway by measuring the absorption of infrared (IR) light of specific wavelengths. CO
2
 has its own 
absorption characteristic and the amount of light passing the gas probe depends on the concentration of the 
measured CO
2
. When a specific band of IR light passes through respiratory gas samples, some of IR light will be 
absorbed by the CO
2
 molecules. The amount of IR light transmitted after it has been passed through the 
respiratory gas sample is measured with a photodetector. From the amount of IR light measured, the 
concentration of CO
2
 is calculated.
CO
2
 measurement are used to monitor the patient’s respiratory status. The following two methods are used for 
measuring CO
2
:
■ Mainstream CO
2 
measurement 
Directly insert a CO
2
 sensor into the patient's breathing system. 
■ Sidestream/Microstream CO
2
 measurement
Take a sample of the respiratory gas with a constant sample flow from the patient's airway and analyze it 
with a remote CO
2
 sensor built into the Sidestream or Microstream CO
2
 module. 
The sidestream CO
2
 module can be configured with a paramagnetic oxygen sensor. The paramagnetic oxygen 
sensor measures oxygen relying on its paramagnetic properties. 
The mainstream CO
2
 measurement can be used, with specified accessories, with intubated adult, pediatric and 
neonatal patients. The sidestream and microstream CO
2
 measurement can be used, with specified accessories, 
with intubated and non-intubated adult, pediatric and neonatal patients. With intubated patients, a sample of 
the respiratory gas is drawn from the patient's breathing circuit through an airway adapter and a gas sampling 
line. With non-intubated patients, the gas sample is drawn through a nasal cannula.
CO
2
 monitoring is intended for adult, pediatric and neonatal patients.
For ePM 12M/ePM 12MA/ePM 12MC, you can monitor CO
2 
using the built-in CO
2
module or the external CO
2
 
module. For ePM 10M/ePM 10MA/ePM 10MC, you can monitor CO
2 
using the external CO
2
 module only. 
The following external modules are sidestream CO
2
 module, microstream CO
2
 module and mainstream CO
2
 
module from left to right.
If you measure CO
2
 using the AG module, see 19Monitoring Anesthetic Gas (AG).
(1) CO
2
 menu hard key (2) CO
2 
Measure/standby hard key
(3) CO
2
 watertrap seat (4) Gas outlet
(5) Sample line connector  (6) CO
2
 sensor connector 
(1)
(2)
(4)
(3)
(1)
(5)
(4)
(1)
(6)
(2)
(2)