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Updated: Aug 17, 2026

A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
Published on: May 4, 2021
Nitrogen diffusion into closed anesthesia systems
Thomas Marx1, Helmuth Reinelt, Kerstin Plotzki
1Department of Cardiac Anesthesia, University of Ulm, Ulm, Germany. thomas.marx@medizin.uni-ulm.de
Objective:
In order to reduce losses of gases through plastic components and to reduce nitrogen accummulation during closed system anaesthesia we investigated either 10 sets of anaesthetic tubing made of silicon as used in standard clinical practice and 10 sets made of latex, which are not used anymore due to concerns about latex allergies. The results were compared to each one set made of conventional industrial rubber.
Methods:
Anaesthetic tubings were connected to ventilators with low fresh gas losses, suitable for closed system anaesthesia. For nitrogen measurements, a mass spectrometer was used. The fresh gas flow was set to exceed losses by leakages and the amount of gases, extracted from the system by the mass spectrometer.
Results:
Highest accumulation of nitrogen was found using tubings made of silicone.
Conclusion:
If closed anaesthetic systems in the future will be used in intensive care therapy or in case of long lasting procedures in which closed system anaesthesia is proceeded, materials other than silicone should be investigated to avoid regular purging of system and consecutive losses of gas mixtures.
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