Measurement of respiratory gas composition by a mass spectrometer lags behind the measurement of gas flow. To obtain specific gas volumes (e.g., the N2 volume) by multiplication and integration of concentration and flow, one has to synchronize flow and concentration signals using the delay time (TD) of the gas analyzer. During the N2 washout, however, gas composition changes and causes alterations of TD. This leads to errors of up to 17 and 70% in the measurement of pulmonary volume and series dead space, respectively, in an ideally mixing physical model of the lung. On the basis of Poiseuille's law and exact measurements of the characteristics of the capillary it is possible to adjust the synchronization, which improves the absolute accuracy considerably.
The LMA improves ventilation, facilitates fibreoptic intubation, and offers the possibility for blind endotracheal intubation in difficult to intubate patients. Blind intubation though the LMA has to be practised extensively to have a high success rate. The LMA represents an additional aid for the anaesthetic management of patients who are difficult to intubate.
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