Evaluation of a small soda lime canister in a to-and-fro system

The main disadvantages of the to-and-fro system (the bulky canister and the progressive increase in apparatus deadspace) may be overcome by the use of a smaller canister. In this laboratory study, we have evaluated a 160 g canister in a low-flow to-and-fro system (fresh gas flow 1 litre/minute). Two carbon dioxide productions of 150 and 200 ml/minute were simulated. The mean times to exhaustion, defined here as a 0.5 kPa rise in end-tidal PCO2, were 112 and 79 minutes in the 150 and 200 ml/minute carbon dioxide groups respectively. Ventilation to normacapnia or hypocapnia did not affect the times to exhaustion. The soda lime absorbed 16 litres of carbon dioxide before exhaustion, and this was not affected by minute volume or carbon dioxide production. A small soda lime canister is suitable for carbon dioxide absorption in a low-flow to-and-fro system for ventilated adults.