Troubleshooting
10-15
Advanced airway gas troubleshooting
Advanced entropy troubleshooting
Symptom
Possible cause and solution
Airway gas values are too
low
•
Check the sampling line and connectors for leakage.
Why can we see dips in
the capnogram during
expiration?
The dips seen in the capnogram during expiration are related to the sidestream
gas sampling, the continuous gas flow to the Y-piece, and patient’s cardiac
contractions, which cause intra-thoracic pressure changes and therefore flow
variations.
Why can we see
variations in the oxygram
during inspiration?
Changes in the fresh gas flow reate and oxygen concentrations affect the
shape of the oxygram during inspiration. Rule out any potential clinical
complications such as hypoventilation, hyperventilation, circuit hypoxia,
disconnection.
Why is the EtCO2 value
considerably lower than
the CO2 partial pressure
determined by blood gas
analysis?
The major clinical reasons are dead-space ventilation, ventilation/perfusion
mismatch, a drop in cardiac output, alveolar shunts, and incomplete emptying
of the alveoli.
Also check the following technical issues: integrity of the breathing circuit;
blood-gas analysis corrected to a lower temperature in case of hypothermia.
NOTE: If you are using N2O and the E-miniC, make sure that the N2O
compensation has been selected in the monitor menu.
Symptom
Possible cause and solution
What does a sudden drop
in values mean?
A sudden drop in values can be caused by the following:
•
Bolus administration of intravenous anesthetics
•
Increase in inhalation anesthesia level
•
Administration of other medication affecting EEG/FEMG
What does an
unexpected increase in
values indicate?
An unexpected increase in values can be caused by the following:
•
Change in infusion pump settings for intravenous anesthetics
•
Change in vaporizer settings, or fresh-gas flow rate
•
Volume loading with infused fluids
•
Fault in the operation of anesthetic delivery systems
•
Impedance check
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