A novel cause of rebreathing carbon dioxide related to removed CLIC-seal on the Dräger Apollo© anesthesia machine.
We present a case report involving two sequential, surgically uneventful, laparoscopic cholecystectomies using the same anesthesia machine (Drager Apollo©) for which the level of inspired carbon dioxide was noted to be elevated following various diagnostic interventions including replacing the sodalime, increasing fresh gas flows, and a full inspection of equipment for malfunction. Eventually it was discovered that a rubber ring seal connecting the Dragersorb CLIC system© to the sodalime canister was inadvertently removed during the initial canister exchange resulting in an apparent bypassing of the absorbent and thus an inability of the exhaled gas to contact the sodalime. To our knowledge this is the first such description of this potential cause of elevated inspired carbon dioxide and should warrant consideration when other conventional interventions have failed.
['Niknam|B|B|', 'Bebic|Z|Z|', 'Roseman|A|A|']
D000758:Anesthesia D000764:Anesthesia, Closed-Circuit D000776:Anesthesiology D018685:Anesthetics, Inhalation D017610:Calcium Compounds D002245:Carbon Dioxide D002763:Cholecystectomy D004867:Equipment Design D004868:Equipment Failure D005260:Female D005740:Gases D006801:Humans D010535:Laparoscopy D008875:Middle Aged D010087:Oxides D015742:Propofol D012408:Rubber D012972:Sodium Hydroxide
Rebreathing Inspired carbon dioxide Sodalime Dragersorb CLIC