In Response

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We agree with Overdyk et al.1 re their major concern that a more noninvasive, unencumbering, continuous respiratory monitor is desperately needed to detect opioid-induced ventilatory impairment. The Joint Commission and the Anesthesia Patient Safety Foundation have both come out in support for this type of monitoring technology.2,3Understanding the shortcomings of capnography in terms of patient tolerance and other limitations,4,5 we decided to evaluate the new noninvasive bioacoustic sensor that has recently become available, in a robust clinical setting, that of the postanesthesia care unit. The postanesthesia care unit is an area with much extraneous noise and activity and also an area where respiratory depression is common in all patients, those with or without sleep apnea. We felt that this would give a good clinical test of the new technology.We did use technicians, hired especially for this trial by the sponsor, to count waveforms and respiratory rates. They were blinded to the study protocol and had no knowledge as to the end points of the study. We agree we could have used a pneumotachometer to count respiratory rate but this did not lend itself to the real clinical situation, which was our test laboratory.We are encouraged by new technologies that are being developed that are patient, tolerant, accurate, and will assist in keeping our patients safe.Conflicts of Interest: Michael A. E. Ramsay, MD, receives research funds from Masimo Corporation and is a Speaker Board member and Advisory Board member for Masimo Corporation. Mohammad Usman, PhD, is an employee of Masimo Corporation.

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