The World Federation of Societies of Anaesthesiologists Minimum Capnometer Specifications 2021—A Guide for Health Care Decision Makers

Abstract

Capnometry, the measurement of respiratory carbon dioxide, is regarded as a highly recommended safety technology in intubated and nonintubated sedated and/or anesthetized patients. Its utility includes confirmation of initial and ongoing placement of an airway device as well as in detecting gas exchange, bronchospasm, airway obstruction, reduced cardiac output, and metabolic changes. The utility applies prehospital and throughout all phases of inhospital care. Unfortunately, capnometry devices are not readily available in many countries, especially those that are resource-limited. Constraining factors include cost, durability of devices, availability of consumables, lack of dependable power supply, difficulty with cleaning, and maintenance. There is, thus, an urgent need for all stakeholders to come together to develop, market, and distribute appropriate devices that address costs and other requirements. To foster this process, the World Federation of Societies of Anaesthesiologists (WFSA) has developed the “WFSA—Minimum Capnometer Specifications 2021.” The intent of the specifications is to set the minimum that would be acceptable from industry in their attempts to reduce costs while meeting other needs in resource-constrained regions. The document also includes very desirable and preferred options. The intent is to stimulate interest and engagement among industry, clinical providers, professional associations, and ministries of health to address this important patient safety need. The WFSA—Minimum Capnometer Specifications 2021 is based on the International Organization for Standardization (ISO) capnometer specifications. While industry is familiar with such specifications and their presentation format, most clinicians are not; therefore, this article serves to more clearly explain the requirements. In addition, the specifications as described can be used as a purchasing guide by clinicians.

The Capnography Project

“…The durability of the introduced capnography device over the time period of the study will also be assessed. Previous work done in Malawi by members of the AG has laid the foundation for this study 16 that is anticipated to start in the summer of 2023.…”

“…14 The plan was to follow a similar methodology (Figure 1). An Advisory Group (AG) consisting of key stakeholders from Smile Train and Lifebox as well as individuals and core partners with expertise in capnography (eg, Global Capnography Project [GCAP], 15 Center for Health Equity in Surgery & Anesthesia [CHESA] at University of California at San Francisco [UCSF], 10 and World Federation of Societies of Anaesthesiologists [WFSA] 16 ) was formed to provide strategic guidance for the project. In addition, a Technical Working Group (TWG) was formed to give regular technical and clinical input.…”

Instructions for a Highly Relevant Tool in Line With the United Nations Goals for Sustainable Development

“…Capnometry devices are usually not available due to relatively high costs, limited durability of devices, difficulty of maintenance, and lack of available consumables. In this issue of Anesthesia & Analgesia , Gelb et al 16 provide the WFSA Minimum Capnometer Specifications, defining the minimum requirements for capnometers. Gelb et al 16 call for industry to reduce costs and to achieve a win-win situation by designing and delivering readily available and inexpensive capnometer technology, with high durability and simple maintenance, as well as an inexpensive and simple supply of consumables.…”

“…In this issue of Anesthesia & Analgesia , Gelb et al 16 provide the WFSA Minimum Capnometer Specifications, defining the minimum requirements for capnometers. Gelb et al 16 call for industry to reduce costs and to achieve a win-win situation by designing and delivering readily available and inexpensive capnometer technology, with high durability and simple maintenance, as well as an inexpensive and simple supply of consumables. This call is fully aligned with the 17th sustainable development goal of the UN, to “strengthen the means of implementation and revitalize the global partnership for sustainable development” (Figure).…”

“…The successful implementation of the “highly recommended” (mandatory) intraoperative monitoring of end-tidal CO 2 for all intubated patients 14 will depend on the joint efforts of civil societies (nongovernmental organizations), public institutions, the private sector, and businesses. Gelb et al 16 provide the recipe for success for developing a highly relevant tool.…”