Anesth Analg 2008; 107:748-
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e31817b65d2
EDITORIAL
It Takes an Entrepreneur
Jeffrey M. Feldman, MD, MSE*
From the *Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia; and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
Capnographs are ubiquitous. On a daily basis, all over the world, physicians, nurses, and respiratory therapists use these devices to monitor patients and guide diagnosis and therapy. These devices reliably measure CO2 breath after breath. The user merely turns on the device and interprets the output. The impact of this technology on patient safety, especially in the practice of anesthesiology, cannot be overstated.
In this issue of the journal, Jaffe has contributed a historical article on the development of infrared mainstream capnometry.1 The CO2 measurement technology we take for granted is the result of more than a century of scientific investigation and commercial development. In the process of developing this article, Dr. Jaffe used historical records, conducted many hours of personal interviews with developers of this technology, and has drawn upon his own expertise after 25 yr as an industrial scientist working on capnometry.
It is remarkable that Tyndall developed the ratio spectrophotometer in the nineteenth century with all the elements of modern capnometry: a source of infrared light, a chamber to contain the sample, and a detector to measure the light that passed through the specimen. Tyndall’s discoveries were fundamental to developing capnometry, but commercial development created the technology used at the bedside today. The early capnometers depicted in Jaffe’s article underscore the fact that miniature electronics, microprocessors, and advances in materials science were all required to make bedside capnometry a reality. The essential ingredient however remains the entrepreneurial spirit. Whether it is the entrepreneur clinician, scientist, or corporate officer, commercialization of technology requires vision and the willingness to accept failure. This is particularly true with medical devices where the market is small, regulations are onerous, potential liability is great, profit margins are thin, and clinicians are frequently skeptical about new technology. Clinicians are understandably suspicious of those with financial interest in a particular technology. However, without entrepreneurs the devices that make modern medical care possible simply would not exist.
The article by Dr. Jaffe benefits from his perspective as a scientist at Respironics—Novametrix. His article offers a broad historical perspective on infrared mainstream capnometry. Both the author and this editor have made efforts to insure that the text does not promote any particular device or company. Since the author is employed by Respironics, competing manufacturers have been invited to submit letters to the journal adding to this historical perspective.
I am pleased that the journal has afforded space in the Technology Section for documenting the history of this ubiquitous and life-saving technology. I hope you enjoy the story!
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Footnotes
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Accepted for publication March 25, 2008.
Address for correspondence and reprint requests to Jeffrey M. Feldman, MD, MSE, Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, 34th and Civic Center Blvd., Philadelphia, PA 19104. Address e-mail to feldmanj{at}email.chop.edu.
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REFERENCE
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- Jaffe MB. Infrared measurement of carbon dioxide in the human breath – "Breathe-Through" devices from Tyndall to the present day. Anesth Analg 2008;107:890–904[Abstract/Free Full Text]
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