Direct, minimally intrusive quantification of rebreathing in the circle breathing system during spontaneous breathing: a proof-of-concept feasibility study

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Background: During spontaneous breathing in the circle breathing system, hypercapnia can occur partly due to the rebreathing in the breathing tubing; however, there is currently no explicit method to quantify this specific portion of rebreathing. Methods: We derived formulas from the ideal gas law to calculate the rebreathing. To conduct an initial proof-of-concept feasibility assessment, we applied these formulas to data from only one pediatric patient-a 5-year-old child under general anesthesia. Spontaneous breathing was maintained with fresh gas flow of 2, 4, and 6 L/min, with real-time monitoring of gas states within the breathing tubing. Results: The total maximum rebreathing volumes originating from the breathing tubing were 0.54 ± 0.05 mL, 0.47 ± 0.03 mL, and 0.43 ± 0.03 mL, respectively, showing a decreasing trend with increasing fresh gas flow. Conclusion: Spontaneous breathing via the circle breathing system leads to rebreathing from the breathing tubing, and the specific value of the rebreathing resulting from the breathing tubing can be calculated using the formulas obtained from the ideal gas law.

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