For decades, patient monitoring with oximetry and capnography has been an ASA standard of care. It is linked with our specialty’s benchmark improvement in outcomes. Yet even now, these tools remain largely unavailable across low- and middle-income countries. Lifebox was founded in 2011 to address the excess and preventable mortality that results from such gaps. Since its inception, Lifebox has distributed more than 35,000 oximeters – designed to be durable and functional in austere conditions – in 116 countries. Until now, the opportunity to introduce a similarly durable and purpose-fit capnograph has been elusive. The need is clear: a study in Malawi documented a 97% “capnography gap.”

This month will see the launch of the SmileTrain-Lifebox Capnograph – an affordable, high-quality device that meets robust specifications for both the monitoring of pediatric patients and for use in low-resource settings. The device was selected through a rigorous international collaboration, including extensive product research, laboratory and field testing, and substantial technical and usability input from key medical experts and stakeholders. SmileTrain’s partnership with Lifebox reflects an appreciation of the special risks of airway mishap in small children undergoing airway surgery, but the device will benefit a broad range of patients.

This new initiative represents a tremendous opportunity to extend ASA’s long history of support for advancing anesthesia care globally. The ASA Charitable Foundation has partnered with Lifebox since its inception, most recently providing aid to anesthesiologists in Ukraine. In addition, the ASA-Lifebox Resident Challenge – won last year by the University of Cincinnati – funded the delivery of 225 pulse oximeters to providers in need. This year’s challenge sets an even more ambitious goal of $80,000. Most importantly, it is also raising funds for the new capnograph, for which the need is enormous. As my colleague, Ugandan anesthesiologist Dr. Mary Nabukenya, noted – working without capnography is like “driving with dim lights, trying to see.”

Anesthesiologist Dr. Renda Suleman, from Yekatit 12 Medical College Hospital, received a SmileTrain-Lifebox Capnograph during pilot testing in Addis Ababa, Ethiopia, and said, “I observed the immediate impact and significant improvement in the care we provide to our patients. My confidence has also tremendously improved because my work is guided by a reliable device.” Not all ORs at Dr. Suleman’s hospital are equipped with capnography, however: “To make the best use of the capnograph, we have to schedule it for use by critical patients only. This means we are forced to discriminate between our patients when all of them should be receiving equal amounts of care.”

Lifebox is raising funds for 50 capnographs during this year’s Resident Challenge. Residents, faculty, and practicing anesthesiologists can come together to advance practice around the world. Find out more and join in at The winning resident team will be announced at ANESTHESIOLOGY® 2023. Please also join us to learn more at the special session “Increasing Access to Capnography in Low-Resource Contexts: Device Specifications, Identification, and Implementation” (Sunday, October 15 from 10-11 a.m., Center Stage, Exhibit Hall) and visit the Lifebox booth (#363).