Case Report about Co - Axial Circuit Causing Hypercarbia

Bain Co - axial anesthesia circuits have been used to administer general anesthesia since 1972. Co - axial circuits have many benefits, however in current anesthesia practice they have one significant pitfall that is undetectable during automated machine checkout. Disconnection of the inner tube of a co - axial breathing circuit leading to hypercarbia and high inspiratory Carbon Dioxide can go unrecognized during machine checkout. We present an anesthetic case where immediately afte r induction of anesthesia, hypercarbia and high inspiratory Carbon Dioxide were recognized. Troubleshooting ensued and a proximal disconnection of the inner tube of the co - axial circuit was discovered. Prior to induction of anesthesia utilizing a co - axial circuit, visual inspection of the circuit integrity should be performed until technology advances and a method is developed to detect this type of disconnection.