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Anatomic dead space is a key concept in respiratory physiology. Because the upper airways do not function as sites of gas exchange and because ventilation is tidal, a fraction of inspired air does not participate in gas exchange.[1] This is therefore termed anatomical dead space as it serves no respiratory function. This phenomenon has clinical significance because, in both healthy and impaired lungs, accurately accounting for this non-physiological space is important for the provision of appropriate respiratory care for ventilated patients. Indeed, it may serve as a prognostic factor in patients with acute respiratory distress syndrome (ARDS) who require ventilation.[2] However, differences in the exact method of measuring this space yield clinically significant differences and, therefore, debate remains about the true value of this measured parameter.[3]