RELIABILITY AND SOURCE OF ERRORS IN END-TIDAL GAS CONCENTRATION EVALUATION ALGORITHMS DURING AVALANCHE SNOW AND REBREATHING EXPERIMENTS

Karel Roubík, Jan Filip

Abstract


During breathing experiments in avalanche snow, measurement of CO2 is often conducted in order to monitor the volunteers or as an endpoint of the trials. From the measured CO2 curves, monitors calculate end-tidal CO2 concentrations (EtCO2). The aim of the study is to investigate, whether Datex-Ohmeda S/5 anesthesia monitor evaluates EtCO2 and other parameters of breathing gas correctly, otherwise to characterize the occurrence of the error and to find out a possible cause of error. Data from a real experiment aimed at investigation of work of breathing into snow in the presence and absence of an artificial air pocket were used to study precision of the monitor. The data were evaluated in Matlab environment. The analysis found that the average error of EtCO2 evaluation occurred in 39% and in 30 % of the total experimental time of breathing with and without the air pocket respectively (range from 13% to 93% of time). Breathing experiments with simulated snow were conducted in order to find the cause of the error. The error occurs immediately after a significant increase of CO2 in the breathing circuit as a consequence of expired gas rebreathing and is independent on other breathing parameters related to a change in breathing pattern. The experiment confirmed that a newer model CARESCAPE B650 monitor is prone to this error as well. The last experiment conducted with a standard anesthesia machine but with removed CO2 absorbing soda lime confirmed, that the error occurs even in a standard clinical setup, which might cause a wrong diagnoses or might harm a volunteer or a patient.

Keywords


hypercapnia; EtCO2; avalanche; snow burial; device error; Datex S/5; CARESCAPE B650

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This work is licensed under a Creative Commons Attribution 4.0 International License.

ISSN 0301-5491 (Print)
ISSN 2336-5552 (Online)
Published by the Czech Society for Biomedical Engineering and Medical Informatics and the Faculty of Biomedical Engineering, Czech Technical University in Prague.