We thank the authors for their comments and appreciate the opportunity to clarify several aspects of our study.

The 12 to 15 ml/kg was not the volume of the first breath after sugammadex, but rather was the tidal volume required during paralysis to alleviate the subjects’ dyspnea. This was the expiratory volume, so the measured values would not have been elevated by any mask leak. Consistent with this, the end-tidal partial pressure of carbon dioxide was between 30 and 35 mmHg during neuromuscular blockade compared to 37 to 42 mmHg before paralysis.

We agree that arterial carbon dioxide measurements would have been ideal; however, in healthy adults the end-tidal closely tracks arterial values. Provided the end-tidal partial pressure of carbon dioxide is measured appropriately from the alveolar plateau, in healthy adults the difference from arterial values is less than 3 to 5 mmHg. The studies cited—one involving...

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