Skip to main content
MedVellum
QuestionsVideosPricing

MedVellum

Fellowship exam preparation across every specialty: source-verified topics, questions in every format, and videos.

Product

  • Specialties
  • Questions
  • Videos
  • Exam tools
  • Pricing

Verification & policy

  • Verified register
  • Editorial policy
  • Privacy
  • Terms

Account

  • Sign in
  • Create account
  • Dashboard
  • Account & billing

© 2026 MedVellum. For education only — not a substitute for clinical judgement.

llms.txtPsychiatry LLM catalogSitemap

ICU TopicsEquipment & physics

ICU · Equipment & physics

Equipment & Physics — Monitors, Humidification, Suction, Ventilators and Safety

Also known as Equipment and physics · Humidification · Endotracheal suctioning · Transport ventilator · Electrical safety · Pulse oximetry · Capnography · Defibrillator · Pressure transducer

ICU equipment by failure mode: pulse-oximetry bias (including skin pigmentation), capnography and its limits, arterial-line dynamic response and line-cuff discrepancy, temperature sites, humidification targets and HME versus heated humidifier outcomes, endotracheal suctioning, transport ventilators, oxygen supply failure, electrical safety, CO2 absorbents and biphasic defibrillation.

high26 referencesUpdated 8 Oct 202610 min readSource-verified · Oct 2026

Checked against its sources on 8 Oct 2026

Practise this topic

  • 16 MCQs

Your progress

Saved on this device.

Practise this topic16 MCQs with explanations

Target exams

CICMFFICMEDICESICMSociety_CCM
On this page
Study tools

Your progress

Saved on this device.

Practise this topic16 MCQs with explanations

Target exams

CICMFFICMEDICESICMSociety_CCM

Why equipment physics matters in the ICU

Every number on an ICU monitor is the output of a device with known failure modes. Pulse oximetry has a documented list of sources of inaccuracy; intra-arterial pressure accuracy depends on the dynamic response of the measuring system; capnography carries limitations as a surrogate for PaCO2; and humidifiers, suction systems, transport ventilators and the oxygen supply each fail in predictable ways.[1][7][5][21] This topic is organised device by device: what the device measures or delivers, how it errs, and what the evidence says about choosing between options.

The five device facts examiners return to
  1. Pulse oximeters overestimate SaO2 in darker skin, particularly at lower saturations, which may delay recognition of hypoxaemia.[3]
  2. Arterial-line accuracy depends on natural frequency and damping, and in many clinical settings the measurement is prone to significant error.[7]
  3. Capnography is not a reliable surrogate for PaCO2 — interpret the whole waveform.[5]
  4. Humidify every invasively ventilated patient, and avoid HMEs with low tidal volumes because of added dead space.[10]
  5. Suction only when secretions are present, without routine saline instillation.[17]
ICU Fellowship (CICM) Pro

Continue reading

You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the ICU Fellowship (CICM) fellowship library.

Sign in to continueSee pricing
References26ShowHide
  1. [1]Moon K, Daino N, Gomez P, et al. Pulse Oximetry-A Perioperative Perspective. Diagnostics (Basel, Switzerland), 2026.PMID 42351472
  2. [2]León-Valladares D, Barrio-Mateu LA, Cortés-Carmona N, et al. Determining factors of pulse oximetry accuracy: a literature review. Revista clinica espanola, 2024.PMID 38599519
  3. [3]Cotton SA, Lee JA, Malhotra A, et al. Do Differences in Skin Pigmentation Affect Detection of Hypoxemia by Pulse Oximetry: A Systematic Review of the Literature. Clinical nursing research, 2025.PMID 41045137
  4. [4]Jubran A Pulse oximetry. Critical care (London, England), 2015.PMID 26179876
  5. [5]Nassar BS, Schmidt GA Capnography During Critical Illness. Chest, 2016.PMID 26447854
  6. [6]Long B, Koyfman A, Vivirito MA Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. The Journal of emergency medicine, 2017.PMID 28993038
  7. [7]Devasahayam S, Gangadharan N, Surekha C, et al. Intra-arterial blood pressure measurement: sources of error and solutions. Medical & biological engineering & computing, 2022.PMID 35235133
  8. [8]Zamith N, Walker C, Scully T, et al. Should I Target the Blood Pressure from the Arterial Line or the Cuff? A Practical Approach for Dealing with Widely Discordant Measurements. Journal of clinical medicine, 2025.PMID 41464519
  9. [9]Jogie J, Jogie JA, Phillip K Perioperative Temperature Monitoring in Anesthesia: A Review of Current Evidence and Clinical Practice. Cureus, 2026.PMID 42147589
  10. [10]American Association for Respiratory Care, Restrepo RD, Walsh BK Humidification during invasive and noninvasive mechanical ventilation: 2012. Respiratory care, 2012.PMID 22546299
  11. [11]Wilkes AR Heat and moisture exchangers and breathing system filters: their use in anaesthesia and intensive care. Part 1 - history, principles and efficiency. Anaesthesia, 2011.PMID 21106035
  12. [12]Wilkes AR Heat and moisture exchangers and breathing system filters: their use in anaesthesia and intensive care. Part 2 - practical use, including problems, and their use with paediatric patients. Anaesthesia, 2011.PMID 21118189
  13. [13]Lellouche F, Taillé S, Maggiore SM, et al. Influence of ambient and ventilator output temperatures on performance of heated-wire humidifiers. American journal of respiratory and critical care medicine, 2004.PMID 15271695
  14. [14]Lacherade JC, Auburtin M, Cerf C, et al. Impact of humidification systems on ventilator-associated pneumonia: a randomized multicenter trial. American journal of respiratory and critical care medicine, 2005.PMID 16126933
  15. [15]Siempos II, Vardakas KZ, Kopterides P, et al. Impact of passive humidification on clinical outcomes of mechanically ventilated patients: a meta-analysis of randomized controlled trials. Critical care medicine, 2007.PMID 18074484
  16. [16]Branson RD Secretion management in the mechanically ventilated patient. Respiratory care, 2007.PMID 17894902
  17. [17]American Association for Respiratory Care AARC Clinical Practice Guidelines. Endotracheal suctioning of mechanically ventilated patients with artificial airways 2010. Respiratory care, 2010.PMID 20507660
  18. [18]Kuriyama A, Umakoshi N, Fujinaga J, et al. Impact of closed versus open tracheal suctioning systems for mechanically ventilated adults: a systematic review and meta-analysis. Intensive care medicine, 2015.PMID 25425442
  19. [19]L'Her E, Roy A, Marjanovic N Bench-test comparison of 26 emergency and transport ventilators. Critical care (London, England), 2014.PMID 25672675
  20. [20]Chipman DW, Caramez MP, Miyoshi E, et al. Performance comparison of 15 transport ventilators. Respiratory care, 2007.PMID 17521464
  21. [21]Botney R, Answine JF, Cowles CE Jr Failures of the Oxygen Supply. Anesthesiology clinics, 2020.PMID 33127035
  22. [22]Zhang J, Lin L, Pan K, et al. High-flow nasal cannula therapy for adult patients. The Journal of international medical research, 2016.PMID 27698207
  23. [23]Burgess RC Electrical safety. Handbook of clinical neurology, 2019.PMID 31277877
  24. [24]Keijzer C, Perez RS, de Lange JJ Carbon monoxide production from desflurane and six types of carbon dioxide absorbents in a patient model. Acta anaesthesiologica Scandinavica, 2005.PMID 15954965
  25. [25]Morrison LJ, Henry RM, Ku V, et al. Single-shock defibrillation success in adult cardiac arrest: a systematic review. Resuscitation, 2013.PMID 23876982
  26. [26]Ahmad I, El-Boghdadly K, Iliff H, et al. Difficult Airway Society 2025 guidelines for management of unanticipated difficult tracheal intubation in adults. British journal of anaesthesia, 2026.PMID 41203471

Test yourself

Practise what you just read

  • 16 MCQs
ICU Fellowship (CICM) Pro

$29/ monthor $279 / year

The complete ICU Fellowship (CICM) library, every exam format, one subscription.

  • Complete library for one chosen specialty
  • Timed MCQ mock exams and spaced review
  • Clinical cases & cross-table vivas
See pricingSign in
PreviousEndocrine PhysiologyPhysiology / endocrineNextHumidification and Airway Warming — Comprehensive (HME vs Active Heated Humidifier, Physics of Humidification)equipment-physics