Breathing resistance in automated metabolic systems is high in comparison with the Douglas Bag method and previous recommendations

The purpose of this study was to investigate the resistance to breathing in metabolic systems used for the distribution and measurement of pulmonary gas exchange. A mechanical lung simulator was used to standardize selected air flow rates ([Formula: see text], L/s). The delta pressure (Δ p, Pa) between the ambient air and the air inside the equipment was measured in the breathing valve’s mouthpiece adapter for four metabolic systems and four types of breathing valves. Resistance for the inspiratory and expiratory sides was calculated as RES = (Δ p/[Formula: see text]) Pa/L/s. The results for resistance showed significant ( p < 0.05) between-group variance among the tested metabolic systems, breathing valves, and between most of the completed [Formula: see text]. The lowest resistance among the metabolic systems was found for a Douglas Bag system which had approximately half of the resistance compared to the automated metabolic systems. The automated systems were found to have higher resistance even at low [Formula: see text] in comparison with previous findings and recommendations. For the hardware components, the highest resistance was found for the breathing valves, while the lowest resistance was found for the hoses. The results showed that resistance in metabolic systems can be minimized through conscious choices of system design and hardware components.