A Cryogenic Machine for Selective Recovery of Xenon

from Breathing System Waste Gases

John Dingley, MD* BACKGROUND: Xenon has many characteristics that make it very attractive as an
anesthetic and therapeutic drug. Unfortunately, the supply of xenon is fixed, and
Rod S. Mason, PhD therefore reclamation and recovery from even the most efficient breathing circuits
is desirable. We built and evaluated a cryogenic device to recover xenon from
waste anesthetic gases.
METHODS: Xenon was selectively frozen to 139.2C from test gas mixtures at ambient
pressure (STP). The machine ran on standard 240 V 13 A electrical current without
refrigerants that required replenishing, e.g., liquid nitrogen. A wide range of
xenon/oxygen mixtures were processed over a range of freezing chamber tempera-
tures. Efflux gas and thawed reclaimed xenon were collected separately. Xenon purity
and yield (fraction recovered) were measured and calculated on each occasion.
RESULTS: Gas was processed at 300 mL/min, and the operating temperature was
139.2 (0.096)C [Mean (sd)]. Purity and yield were 90% and 70% for gas
mixtures containing 20% xenon, increasing to 95% and 85%, respectively,
with an input gas xenon fraction 40%. Efficiency improved linearly with reducing
temperature.
CONCLUSIONS: Xenon of high purity (90%) and yield (70%) for such a machine
was recovered from all gas mixtures containing 20% xenon. The operating
temperature of the freezing chamber is a major influence on the efficiency of
recovery.
(Anesth Analg 2007;105:13128)

X enon is a noble gas with many attractive anesthetic

properties such as favorable hemodynamics, minimal
side effects, and fast onset/emergence (1 8). It has
been licensed as an anesthetic in Russia (2002) and
Europe (2007). Xenon may also be a potent neuropro-
tectant against hypoxic/ischemic brain injury (9 15).
Proposed therapeutic uses include perinatal asphyxia
(15), cognitive deficit reduction after cardiac surgery
(16,17), and stroke (18).
If xenon does find a clinical role as an anesthetic
or therapeutic agent, practical methods must be
found to minimize xenon consumption per patient
episode because of its scarcity (approximate cost
US$10 per liter). Xenon is a by-product of industrial
oxygen production from the liquefaction of air.
Annual global production is therefore relatively
fixed at approximately 9 12 million liters. If solely
From the *Clinical School, and Department of Chemistry,
University of Wales Swansea, Singleton Park, Swansea, UK.
Accepted for publication June 4, 2007.
Supported by Department of Health, London, UK; New and
Emerging Applications of Technology (NEAT) funded project
AO94.
Reprints will not be available from the author.
Address correspondence to John Dingley, MD, University of Wales
Swansea, The Grove Building, Singleton Park, Swansea SA2 OUL, UK.
Address e-mail to john.dingley@morrnhst-tr.wales.nhs.uk.
Copyright 2007 International Anesthesia Research Society
DOI: 10.1213/01.ane.0000278148.56305.72
used in medicine, this would still only be approxi-
mately 800,000 anesthetics/treatments, even if xe-
non availability per patient was severely restricted
to, for example, 15 L. The notion that the price of
xenon will decrease as demand increases cannot be
assumed, as liquefying additional air purely to
extract xenon would be prohibitively expensive in
energy terms. Given this fixed supply, recovery
methods could help to conserve xenon. The blood
solubility of xenon is much lower than that of other
anesthetics (blood/gas solubility ratio 0.0115) and
uptake from the lungs is also very low (19). Conse-
quently, although conventional circle anesthesia
systems are usually considered to be gas-efficient,
when used with xenon most of the xenon is still lost
as waste gas. Even with a fresh gas flow (FGF) as
low as 500 mL/min, 80% of the supplied xenon is
lost as waste and if higher initial flows are used to
enhance wash-in; the waste fraction is even larger
(20 22). However, the low solubility and uptake
properties suggest that closed circuit breathing sys-
tems, where FGF matches patient uptake with no
spill, might prove unusually gas-efficient with
xenon (19). This is borne out by the closed circuit in
vivo xenon consumption data of Luttropp et al. (6.5
L for initial 15 min and 2.5 L/h thereafter) and
Ferrari et al. (13 L for initial 30 min then 3.69 L/h
thereafter) (23,24). Other groups have also success-
fully used closed circuit xenon delivery systems

1312 Vol. 105, No. 5, November 2007

(24 29). Therefore, by optimizing breathing sys-
tems, this scarce resource can be used both respon-
sibly and at acceptable cost. Clearly, because of
limited supply, methods that could produce further
efficiency gains are worthy of investigation, and
xenon recovery is the next logical step.
There are two general approaches to xenon
recycling/recovery.
1. Collection of all waste gases by compression into
cylinders for reprocessing by the gas manufac-
turer: As much as 60% of the xenon used has
been recovered in this way (24).
2. Selective recovery of xenon from waste gas mixtures.
One method used in Russia is to selectively
adsorb xenon onto molecular sieve material,
returning the saturated canisters to the gas manu-
facturer (20). Xenon liquefies at 108C, whereas
oxygen and nitrogen liquefy at 182.9C and
195.79C, respectively. At or below its freezing
point (111.7C), xenon should selectively freeze
from such a gas mixture, and this has been
achieved using liquid nitrogen coolant (20). In a
variation of this method, waste gases have been
compressed to increase the freezing point of each
gas, so that more modest cooling could then be
used to freeze out the xenon. However, under
pressure, the other gases present tend to dissolve in
the liquefying/solidifying xenon, reducing its final
purity (30).
The advantages of cryogenic approaches over
adsorption methods include no gas contamination
by the process itself and a more easily sterilized gas
pathway.
Our first objective was to design and construct an
automated ambient pressure cryogenic machine
with a removable sterilizable freezing chamber that
did not rely on cryogenic liquids, which evaporate
and need replenishing as the cooling method. The
second objective was to experimentally evaluate the
design.
METHODS
Description of Apparatus
The final freezing chamber design consisted of an
elongated tapered cylinder with proximal inlet and
distal outlet ports (Fig. 1). This fitted into a corre-
sponding port in the refrigeration system, permitting
easy removal for cleaning/sterilization. This chamber
contained copper rings to present a large surface area
for xenon to freeze onto and to allow even heat
transfer throughout its interior.
The refrigeration unit comprised three stages, one
precooling the refrigerant circulating in the next stage
until a final working temperature in the freezing
chamber of 139.2C was attained (NBS Cryoresearch
Ltd., Tollesbury, UK) (Fig. 2). This was the lowest
temperature the machine could achieve after several
Vol. 105, No. 5, November 2007
Figure 1. Cutaway view of the freezing chamber. This is
inserted into the refrigeration unit via one end of a thermally
insulated housing, seen on the right of the figure, permitting
removal for sterilization. Being tapered, the distal end is
slightly smaller in diameter than the proximal end. On
insertion into a socket of equivalent shape within the
refrigeration unit the tapers lock against each other creating
a good thermal connection with the cooling mechanism
inside.
design modifications, as pilot studies had demon-
strated that temperatures well below the freezing
point of xenon were needed to maximize yield. The
first stage dissipated the heat energy via an air-cooled
radiator. Each stage was thermally insulated. The
refrigerants were: Stage 1, R404A (150 g); Stage 2,
R508B (110 g); and Stage 3, R14 (86 g) R290 (8 g). The
design included an ultrasonic (1 MHz) xenon analyzer
(Minison, Thomas Swan and Co. Ltd., Cambridge,
UK) (29,31,32). All gas storage bags were metallic to
reduce xenon losses by diffusion (Hans Rudolph, Inc.,
KS City, MO).
A control unit was built and programmed by one of
the authors (JD) (Fig. 3).
Experimental Evaluation
Pilot Experiments
Operating temperature. In one pilot experiment, a 50%
xenon/50% oxygen mixture was pumped through a
freezing chamber being slowly cooled in 1 increments,
while the xenon content of the unfrozen efflux gas was
measured. We found that to maximize yield we needed
to operate the machine at temperatures substantially
lower than the freezing point of pure xenon, to maxi-
mally skew the xenonsolid equilibrium by sublimation
with xenongas towards the solid form. For example, the
xenon concentration in the unfrozen efflux gas was
almost 15% at a temperature of 115C, but this could be
reduced to less than half this value at 139.2C.
Gas flow rate. At 500 mL/min efficiency decreased
due to heating of the chamber by the incoming bulk
gas flow. Later evaluations were performed at 300
mL/min processing flow to allow a safety margin.
Main Experiments
Purity and yield for different input gas mixtures.
Gas storage bags were connected to the two outlets to
collect unfrozen efflux gas and the xenon produced
during the thaw cycle. Input gas for processing was
contained in a similar bag on the machine gas inlet.
2007 International Anesthesia Research Society 1313

Figure 2. Freeze cycle: Gas to be processed is contained in
bag (A). This is pumped via an inlet port (B) through the
freezing chamber at 139.2C (C) where the xenon selec-
tively solidifies. The remaining gases (efflux gas) emerge
from the distal end of the chamber, pass through the xenon
analyzer (D) and are directed by the outlet valve (E) to
atmosphere via hose (F). The xenon analyzer displays the
xenon content of the efflux gas which should be low. Thaw
cycle: The gas pump stops, inlet port (B) automatically
closes, the chamber temperature increases to 100C where-
upon the xenon in the freezing chamber (C) thaws, becomes
gaseous and expands out via analyzer (D) to the outlet valve
(E), which now directs the xenon via hose (G) to a collection
bag. The valves are all oxygen compatible (Model E3A. ACL
srl. Caponago, Italy). The microprocessor system (H) con-
trols the valves, gas pump, and the temperature of the
chamber during each freeze/thaw cycle. The refrigeration
unit forms the base of the machine (I).
The machine functioned automatically under com-
puter control. Once the chamber had cooled to
139.2C, the inlet valve opened and a gas pump
propelled the gas to be processed through the freezing
chamber. The xenon froze, forming xenon ice,
whereas the unfrozen efflux waste gas from the cham-
ber outlet was directed to a gas collection bag. After 5
L of gas had been processed, the pump stopped, the
inlet valve closed and the chamber warmed to
100C, allowing frozen xenon to thaw to gas. The
chamber outlet valve changed, to direct the expanding
xenon gas to a xenon collection bag. After each run,
the volume of gas in the efflux waste and xenon
storage bags (V1) and (V2) was measured by emptying
each bag in aliquots with a calibrated 200-mL syringe.
The purity of recovered xenon was measured using
the xenon analyzer. This analyzer has been extensively
evaluated and found to be very accurate relative to a
1314 Selective Xenon Recovery System
gold standard laser refractometer method (mean
difference of 0.74% and 2 standard deviation limits
of agreement of 1.08% to 2.56%) (33). We applied a
slight correction factor (multiply ultrasonic reading by
0.9835) derived from this previous work to improve
accuracy.
The above-mentioned procedure was repeated with
a series of five different oxygen/xenon input gas
mixtures. Three complete series of measurements
were made.
Relationship between efflux xenon concentration
and freezing chamber temperature. In pilot studies,
we observed that even when the chamber was sub-
stantially below the freezing point of xenon, some
xenon always remained unfrozen. To further investi-
gate the impact of freezing chamber temperature on
xenon recovery, a 50% xenon/50% oxygen input gas
mixture was passed through the chamber at a series of
sequentially decreasing and then increasing tempera-
tures with the percentage xenon in the efflux gas
noted at each step.
RESULTS
Results are shown in Table 1. The mean freezing
chamber temperature was 139.2 (0.1), at an ambi-
ent temperature of 19.5 (1.7)C mean (sd). It was
noted that xenon always started to thaw at a chamber
temperature of between 107C and 108C, in-
keeping with the quoted boiling point of 107C
3C (32). Purity and yield are shown graphically in
(Fig. 4).
The volume of gas processed was measured by
summation of the gas volume in the xenon and waste
gas collection bags after each run (Table 1, columns 3
and 5). There was a small difference between the
calculated total xenon content of the gas being pro-
cessed and that of the same gas once processed. This
could result, for example, from under-measurement of
the xenon collection bag or over-measurement of the
waste gas bag volumes. The opposite measurement
error could cause a slight apparent xenon gain.
Yield calculations could therefore be performed in two
different ways. Although there is very little practical
difference between the results of either calculation, for
the purpose of Figure 4, we have erred on the side of
caution and presented the lowest, most conservative
yield values.
The xenon concentration in the efflux gas was
rather independent of the concentration in the input
gas (Fig. 5). The freezing chamber temperature influ-
enced the efficiency of recovery, as evidenced by the
percentage of xenon present in the efflux gas, which
increased as temperature increased (Fig. 6).
DISCUSSION
This study demonstrated that the device developed
for cryogenic recovery of xenon from waste anesthetic
gases was able to extract xenon reliably, and that the
ANESTHESIA & ANALGESIA
Figure 3. Control algorithm for the machine.

Table 1. Performance of Machine with a Series of Test Gas Mixtures of Varying Xenon Content
Efflux waste Xenon recovery Xenon recovery
Input gas Input gas xenon Efflux waste gas gas xenon bag volume bag xenon
volume (mL) concentration (%) volume (mL) concentration (%) (mL) concentration (%)
5100 48.9 2950 7.5 2150 96.1
5650 39.0 3650 7.0 2000 98.2
4610 27.9 3400 6.8 1210 94.1
4730 20.4 3950 6.8 780 90.4
4560 10.6 4300 6.8 260 72.5
5940 48.2 3350 7.2 2590 95.8
6160 40.0 3900 7.1 2260 96.1
5560 29.8 4150 7.0 1410 94.8
5890 20.8 4900 6.8 990 92.2
5600 10.7 5300 6.8 300 73.4
6600 49.2 3620 7.3 2980 97.7
6360 39.7 4040 7.4 2320 96.5
6290 30.0 4700 7.1 1590 95.3
5545 20.1 4690 7.1 855 92.4
5610 10.5 5330 7.1 280 76.7
All gas processed at 300 mL/min. Ambient temperature 19.5 (1.7)C. Cooling chamber temperature 139.2 (0.1)C Mean (SD).

Vol. 105, No. 5, November 2007 2007 International Anesthesia Research Society 1315

Figure 4. Purity and yield of recovered xenon relative to the
xenon content of the input gas (flow, 300 mL/min; tempera-
ture, 139.2C).
purity of the extracted xenon exceeded 90%. The
percentage unfrozen xenon in the efflux gas is mainly
determined by the temperature of the freezing cham-
ber and independent of the input gas xenon fraction.
Since the experiments were performed at atmospheric
pressure, the expected percentage of unfrozen xenon
can be derived from the vapor pressure. At 139.2C,
the machine operated exactly as predicted from pub-
lished physical chemistry data; however, at tempera-
tures close to its freezing point, the efficiency of xenon
recovery appeared to be much better than predicted
(Fig. 6) (32). This requires some consideration.
The published vapor data in the 139 to 112
temperature range are for xenon gas in equilibrium
(by sublimation) with frozen solid xenon. However,
before multiple layers of solid xenon can form, gas
will first be adsorbed onto the surfaces of the copper
rings in the freezing chamber. Xenon adsorbs much
more readily to copper than to its own solidified
molecules (i.e., xenon ice); therefore, the intense
cooling we used may not be required if the copper
surface area can be increased (34).
Also, the xenon content decreases as the gas moves
along the chamber. Further xenon can only reach the
distal chamber by diffusion from the proximal section
(diffusion limited transport).
It is clear that we observed the mixed effects of
several processes. Potential improvements to the de-
sign would include the use of a honeycomb structure
within the freezing chamber to increase the copper
surface area (for which xenon has a high affinity) and
a further reduce operating temperature.
The gas processing rate could also be improved.
Currently, every 5 L of gas processed takes 53 min,
mostly due to the pauses in processing during cooling
and thawing. The heat transfer (removal) rate from the
1316 Selective Xenon Recovery System
gas as it passes through the freezing chamber can be
estimated, from the heat capacities of oxygen and
xenon, to be approximately 52 J/min. Improving heat
transfer properties where the chamber and its outer
cooling sleeve are in contact would permit both
faster gas flows and more rapid freeze/thaw cycling
times.
For a 70% xenon, 30% O2 inhaled gas mixture
(approximately 1 MAC), collection of useful gas for
recovery could include: gas flushed from a closed
breathing system to counteract N2 build up, xenon-
rich gas remaining in the circle and that eliminated
from the body in the first few exhaled breaths at the
end of an anesthetic. This would likely produce sev-
eral liters of gas with 20% xenon content, from
which our machine should be able to recover 70% of
the xenon.
For xenon, very low-flow circuits are not as efficient
as one might assume and it is clear that xenon
recovery in this situation would greatly reduce overall
xenon use. For example, Burov et al. (20,35) described
a very-low flow protocol in which anesthesia is main-
tained with FGFs of 300 mL/min xenon and 300
mL/min oxygen. If, during maintenance, we assume
typical uptake values of 60 mL/min xenon and 250
mL/min oxygen (metabolic), this would still generate
an overspill or wastage rate of 240 mL/min (14.4 L/h)
xenon (i.e., 80% of the xenon FGF) and 3 L/h oxygen.
A closed-circuit breathing system would be a better
choice of breathing system as it would minimize the
volume of gas to be processed (36).
From these closed-circuit breathing systems, the
waste gas collected would mainly be produced by
denitrogenation circle flushes with fresh gas, re-
sidual xenon purged from the circle, and the initial
exhaled gas collected during emergence from anesthe-
sia. This gas would again be rich in xenon. By extrapo-
lation of data from Luttropp et al. and Ferrari et al. (in
which a denitrogenation flush was included) a 2-h
closed circle anesthetic would consume 10.9 L ($109)
and 18.6 L ($186) of xenon, respectively (23,24). Fur-
thermore, by returning all waste gas collected in this
way to the xenon manufacturer, Ferrari et al. (24)
managed to recover 60% of the total xenon used. The
cost of industrially reprocessed xenon has been
estimated at $3 per liter, and thus if 60% could be
recycled, this would reduce the above estimates for a
2-h anesthetic from $109 $186 to $63$108. It is likely,
therefore, that even with closed-circuit breathing sys-
tems, a recovery device could still usefully reduce
overall xenon consumption per anesthetic, a 50%
reduction perhaps being a realistic target. By combin-
ing xenon recovery with closed circuit use, it is
conceivable that a 2-h administration for anesthesia or
neuroprotection could be achieved using less than 10
L xenon overall.
There are a number of issues that would have to be
addressed before a cryogenic machine of this type could
be used in a clinical setting. Waste gas from a circle
ANESTHESIA & ANALGESIA
Figure 5. Xenon content of efflux gas from
freezing chamber is not materially affected by
xenon content of the input gas being processed
(flow, 300 mL/min; temperature, 139.2C).
Figure 6. Relationship between the xenon con-
tent of the unfrozen efflux gas and the chamber
temperature. Input gas was a 50% oxygen/50%
xenon mixture. Measurements were taken in
decreasing and then increasing temperature
steps. Predicted values derived from vapor pres-
sure data (xenongas over xenonsolid) taken from
published literature are also shown (32).
system might be very humid, containing carbon dioxide
and possibly volatile anesthetic vapors. These could be
removed by removing gas for processing from a point
distal to the circle soda lime canister to ensure carbon
dioxide removal, by using a dehumidification chamber
containing silica gel beads for example or by using a
volatile vapor adsorbent, such as activated charcoal, as
seen in the Physioflex closed circuit machine (37). Alter-
natively, a precooling chamber at approximately
50C could selectively freeze water vapor, volatiles,
and any residual carbon dioxide.
From a legal perspective, the recovery process
could be considered the manufacture of a medical gas
and the operator to be a medical gas manufacturer,
responsible for its medical purity (typically 99.9% or
above) and freedom from microbial contamination. If
recovered xenon were only to be reused during the
same patient anesthetic then, so long as the gas
Vol. 105, No. 5, November 2007
pathways could be sterilized between patients, the
sterility of the gas itself would be less of an issue than
if recovered xenon were intended for other patients.
Although the removable chamber can be sterilized
more readily than, for example, membrane or zeolite-
based devices, sterility concerns over the gas itself
mean that, realistically, recycling would need to be
restricted to the same patient episode only. It is more
likely that such a device might form part of a theater
complex central xenon recovery facility, from which
the relatively pure xenon could be returned at inter-
vals to a gas manufacturer for final purification,
sterilization, and recertification as a medical gas.
In conclusion, we have demonstrated that an auto-
mated xenon recovery machine running on 240 V AC,
13 A standard electrical current with autoclavable
components is technically feasible. It functioned, as
intended, without the use of refrigerants (e.g., liquid
2007 International Anesthesia Research Society 1317
nitrogen) that require replenishment. Within-patient
xenon recycling and reuse might prove feasible, but
concerns over purity, gas sterility, and legal issues
preclude interpatient xenon reuse. A machine such as
this might be best suited for use in a central xenon
recovery facility. Even with the most efficient breath-
ing systems, this recovery method could still usefully
reduce overall xenon consumption. Such unusual at-
tention to detail may be necessary if xenon finds a
clinical role as a neuroprotective drug, since demand
could easily outstrip a fixed supply. Regardless of the
purchase price, medical xenon will always be a scarce
commodity. Ten liters of xenon per 2 h delivery period
may be a realistic overall target using closed circuit
breathing systems in combination with a xenon recov-
ery device of this type.
ACKNOWLEDGMENTS
The authors thank Dr. Alexei Moozyckine, Swansea, UK,
for technical assistance; Mr. John Minister, NBS Cryore-
search, Tollesbury, UK, for advice and construction of part of
the machine; Dr. Per Blom and Wolfgang Shmehl of Linde
Gas therapeutics, Lidingo, Sweden for donation of xenon gas.
REFERENCES
1. Boomsma F, Rupreht J, Man in t Veld AJ, de Jong FH, Dzoljic
M, Lachmann B. Haemodynamic and neurohumoral effects of
xenon anaesthesia. A comparison with nitrous oxide. Anaesthe-
sia 1990;45:273 8
2. Dingley J, King R, Hughes L, Terblanche C, Mahon S, Hepp M,
Youhana A, Watkins A. Exploration of xenon as a potential
cardiostable sedative: a comparison with propofol after cardiac
surgery. Anaesthesia 2001;56:829 35
3. Goto T, Hanne P, Ishiguro Y, Ichinose F, Niimi Y, Morita S.
Cardiovascular effects of xenon and nitrous oxide in patients
during fentanyl-midazolam anaesthesia. Anaesthesia 2004;
59:1178 83
4. Luttropp HH, Romner B, Perhag L, Eskilsson J, Fredriksen S,
Werner O. Left ventricular performance and cerebral haemo-
dynamics during xenon anaesthesia. A transoesophageal
echocardiography and transcranial Doppler sonography
study. Anaesthesia 1993;48:10459
5. Marx T, Froeba G, Wagner D, Baeder S, Goertz A, Georgieff M.
Effects on haemodynamics and catecholamine release of xenon
anaesthesia compared with total i.v. anaesthesia in the pig. Br J
Anaesth 1997;78:326 7
6. Preckel B, Mullenheim J, Moloschavij A, Thamer V, Schlack W.
Xenon administration during early reperfusion reduces infarct
size after regional ischemia in the rabbit heart in vivo. Anesth
Analg 2000;91:132732
7. Goto T, Saito H, Nakata Y, Uezono S, Ichinose F, Morita S.
Emergence times from xenon anaesthesia are independent of
the duration of anaesthesia. Br J Anaesth 1997;79:5959
8. Rossaint R, Reyle-Hahn M, Schulte Am Esch J, Scholz J, Scherpereel P,
Vallet B, Giunta F, Del Turco M, Erdmann W, Tenbrinck R,
Hammerle AF, Nagele P. Multicenter randomized comparison of
the efficacy and safety of xenon and isoflurane in patients under-
going elective surgery. Anesthesiology 2003;98:6 13
9. Petzelt C, Blom P, Schmehl W, Muller J, Kox WJ. Prevention of
neurotransmitter over-release by xenon. J Anasth Intensivbe-
handl 2002;2:S117
10. Ma D, Wilhelm S, Maze M, Franks NP. Neuroprotective and
neurotoxic properties of the inert gas, xenon. Br J Anaesth
2002;89:739 46
11. Petzelt C, Blom P, Schmehl W, Muller J, Kox WJ. Prevention of
neurotoxicity in hypoxic cortical neurons by the noble gas
xenon. Life Sci 2003;72:1909 18
12. Petzelt C, Blom P, Schmehl W, Mueller J, Kox W. Xenon
prevents cellular damage in differentiated PC-12 cells exposed
to hypoxia. BMC Neurosci 2004;5:55
1318 Selective Xenon Recovery System
13. Homi HM, Yokoo N, Ma D, Warner DS, Franks NP, Maze M,
Grocott HP. The neuroprotective effect of xenon administration
during transient middle cerebral artery occlusion in mice.
Anesthesiology 2003;99:876 81
14. Ma D, Yang H, Lynch J, Franks NP, Maze M, Grocott HP. Xenon
attenuates cardiopulmonary bypass-induced neurologic and
neurocognitive dysfunction in the rat. Anesthesiology 2003;
98:690 8
15. Dingley J, Tooley J, Porter H, Thoresen M. Xenon provides
short-term neuroprotection in neonatal rats when administered
after hypoxia-ischemia. Stroke 2006;37:501 6
16. Arrowsmith JE, Grocott HP, Reves JG, Newman MF. Central
nervous system complications of cardiac surgery. Br J Anaesth
2000;84:378 93
17. Grocott HP. Cerebral injury during cardiac surgery: under-
standing the need for a neuroprotective strategy. J Anasth
Intensivbehandl 2002;2:45 6
18. Altschuler EL. Xenon as neuroprotectant in acute stroke? Med
Hypotheses 2001;56:227 8
19. Goto T, Suwa K, Uezono S, Ichinose F, Uchiyama M, Morita S.
The blood-gas partition coefficient of xenon may be lower than
generally accepted. Br J Anaesth 1998;80:255 6
20. Burov NE, Makeev GN, Potanov VN, Kornienko L. Alternative
means for reducing the cost of xenon anesthesia. Anesteziol
Reanimatol 1997:71 4
21. Lynch C III, Baum J, Tenbrinck R. Xenon anesthesia. Anesthe-
siology 2000;92:865 8
22. Nalos M, Wachter U, Pittner A, Georgieff M, Radermacher P,
Froeba G. Arterial and mixed venous xenon blood concentra-
tions in pigs during wash-in of inhalational anaesthesia. Br J
Anaesth 2001;87:497 8
23. Luttropp HH, Thomasson R, Dahm S, Persson J, Werner O.
Clinical experience with minimal flow xenon anesthesia. Acta
Anaesthesiol Scand 1994;38:1215
24. Ferrari A, Erdmann W, Del Tacca M, Formichi B, Volta CA,
Ferrari E, Bissolotti G, Giunta F. Xenon anesthesia: clinical
results and recycling of gas. Appl Cardiopulm Pathophysiol
1998;7:1535
25. Luttropp HH, Rydgren G, Thomasson R, Werner O. A
minimal-flow system for xenon anesthesia. Anesthesiology
1991;75:896 902
26. Lachmann B, Armbruster S, Schairer W, Landstra M, Trouwborst
A, Van Daal GJ, Kusuma A, Erdmann W. Safety and efficacy of
xenon in routine use as an inhalational anaesthetic. Lancet
1990;335:14135
27. Tenbrinck R, Hahn MR, Gultuna I, Hofland J, van Dijk G,
Baumert J, Hecker K, Erdmann W. The first clinical experiences
with xenon. Int Anesthesiol Clin 2001;39:29 42
28. Bedi A, Murray JM, Dingley J, Stevenson MA, Fee JP. Use of
xenon as a sedative for patients receiving critical care. Crit Care
Med 2003;31:2470 7
29. Dingley J, Findlay GP, Foex BA, Mecklenburgh J, Esmail M,
Little RA. A closed xenon anesthesia delivery system. Anesthe-
siology 2001;94:173 6
30. Bader S, Brand T. Reclaiming volatile and gaseous anesthetics.
Anasthesiol Intensivmed Notfallmed Schmerzther 1997;32:46 8
31. Greenspan M. Propagation of sound in five monoatomic gases.
J Acoust Soc Am 1956;28:644 8
32. Lide DR. Handbook of chemistry and physics. 73rd ed. Boca
Raton, FL: CRC Press, 1992
33. King R, Bretland M, Wilkes A, Dingley J. Xenon measurement in
breathing systems: a comparison of ultrasonic and thermal
conductivity methods. Anaesthesia 2005;60:1226 30
34. Da Silva JL, Stampfl C, Scheffler M. Adsorption of Xe atoms on
metal surfaces: new insights from first principles calculations.
Phys Rev Lett 2003;90:066104
35. Burov NE, Kornienko L, Makeev GN, Potapov VN. Clinical and
experimental study of xenon anesthesia. Anesteziol Reanimatol
1999:56 60
36. Baum JA. New and alternative delivery concepts and tech-
niques. Best Pract Res Clin Anaesthesiol 2005;19:41528
37. Nathan N, Sperandio M, Erdmann W, Westerkamp B, Van Dijk
G, Scherpereel P, Feiss P. PhysioFlex: a target-controlled self-
regulating closed-circuit inhalation anesthesia regulator. Ann Fr
Anesth Reanim 1997;16:534 40
ANESTHESIA & ANALGESIA