During clinical anesthesia, the study of CO 2 kinetics is restricted mostly to evaluation of capnography. Capnography, the measurement and graphic display of airway opening CO 2 concentration versus time, is used to confirm correct placement of the tracheal tube and to estimate the adequacy of pulmonary ventilation. However, the study of CO 2 kinetics can offer a rich array of respiratory, cardiovascular, and metabolic information, 6 , 7 , 9 both during traditional steady-state analysis and during the relatively newer study of non–steady-state conditions. In this article, I review the role of capnography in the study of traditional steady-state CO 2 kinetics. We explore exciting new methodology that can monitor CO 2 storage and transport in the body. Then we use these monitoring tools to examine clinically relevant examples of CO 2 kinetics pathophysiology during non–steady states that occur relatively commonly during anesthesia. Accordingly, this review of CO 2 kinetics during anesthesia incorporates the following scheme: • CO 2 kinetics: generation of the normal capnogram; main-stream versus side-stream sampling capnometry • Capnogram: monitoring of airway patency and pulmonary ventilation • Capnogram: mechanical and pathophysiologic effects • Steady-state CO 2 kinetics: effects on alveolar P co 2 , with special emphasis on the effect of alveolar dead space • New methodology to examine CO 2 kinetics during non–steady state: CO 2 expirogram (plot of exhaled P co 2 versus tidal volume), average alveolar expired P co 2 versus end-tidal P co 2 , CO 2 volume exhaled per breath • Non–steady-state conditions: effects on CO 2 kinetics; pathophysiology includes abrupt decrease in cardiac output, application of positive end-expiratory pressure, and pulmonary embolism • Future directions: gas exchange and metabolic monitoring in the next century Table 1 provides a legend and summary of abbreviations.