AANA journal course: new technologies in anesthesia: update for nurse anesthetists--monitoring ventilation and compliance with Side Stream Spirometry.

A new anesthesia technology, Side Stream Spirometry, now allows clinicians to monitor pressure, volume, flow, compliance, and resistance during routine anesthesia practice. Continuous monitoring with Side Stream Spirometry is a major adjunct to patient safety because numerical and visual references show how change in one respiratory parameter affects the mechanics of the entire breath cycle. To optimize ventilation and ensure adequate oxygenation, it is common practice for clinicians to verify that the proper volume per breath is being delivered to the patient at the lowest possible pressure. For artificial ventilation to be most physiologic, each breath must be delivered with the most appropriate flow, at the required volume, under the pressure appropriate for each patient's pulmonary system, and at the correct respiratory breath rate. Side Stream Spirometry makes it possible to continuously measure lung mechanics and the gas dynamics of flow, volume and pressure. Using a simple sensor, the D-lite, Side Stream Spirometry is compatible with all common models of anesthesia machines, ventilators and breathing circuits. Side Stream Spirometry measures all parameters closest to the patient, at the tracheal tube or mask. This sensor location provides actual patient information which is not altered by the volume of gas compressed in the breathing circuit, the absorber system, or in the bellows of the ventilator. This installment of the AANA Journal Course will discuss the technology of Side Stream Spirometry and its application to monitoring pulmonary ventilation. Clinical evidence of ventilatory changes will be graphically demonstrated using the CAPNOMAC ULTIMA, a respiratory gas monitoring system, equipped with Side Stream Spirometry.