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Oxygen and the aerobic metabolism is the fundamental basis for all human life. Everything from the intra-uterine growth of the fetus to the very end of life requires an adequate oxygenation of the transport media, the blood, and from that all cells within the body rely on receiving an adequate supply of oxygen. In the atmosphere around the earth, the volume of oxygen is a fixed 21 vol.% of oxygen is present. The medical world has known for a long while that it is not only an adequate oxygen fraction that is necessary but also an adequate partial oxygen pressure to ensure the proper transport from the lung into the blood.

Medicinal oxygen is also a fundamental part of the fresh gas flow during general anesthesia and in combinations with either nitrous oxide or air in proportions of 1:2 l/min. It is used in operating theatres throughout the world. Medicinal oxygen is the standard of care for certain CO intoxications. Normo-baric high flow oxygen therapy or in severe cases hyperbaric oxygen therapy is today the gold standard of care for carbon monoxide poisoning.


Liquid nitrogen provides temperatures as low as -196°C and it can be used for cryobiology and cryotherapy. The low temperature is used in cryoconservation for the long term preservation of blood, blood components, other cells, body fluids or tissue samples.

In cryosurgery, medical nitrogen can be used, for example, for minor surgical procedures such as the obliteration of warts in dermatology.

It is also used as a component in many gas mixtures and as a displacement medium for sterile equipment, non-oxidizing displacement medium in pharmaceutical vials and as a propellant in pressurized aerosol dispensers. Medical nitrogen provides a source of pneumatic pressure for powering gas-operated medical devices and as a coolant for carbon dioxide surgical lasers.


Medical carbon dioxide is used for various medical purposes such as: Insufflation gas for minimal invasive surgery (laparascopy, endoscopy, arthroscopy) to enlarge and stabilize body cavities for better visibility of the surgical field.

In its liquid phase, where it provides temperatures of down to - 76o C, for cryotherapy or for local analgesia by external application onto the skin surface.


Medicinal air is used mainly for ventilation and inhalation therapy as well as a carrier gas for narcotic substances in inhalation anesthesia.

Pulmonary nebulizer machines or "nebulizers" are used to give routine medication treatments of inhaled bronchodilators to very young children who have problems using metered dose inhalers and spacers. Medicinal air is used to drive room air through tubing to the nebulizer. The nebulizer converts the liquid medication into a mist that can then be inhaled directly into the lungs.


Medicinal nitrous oxide has well-known and well-documented dose-dependent analgesic and mild anesthetic effects with a MACawake of about 60 vol.% and a MACincision of about 110 vol.%. Nitrous oxide is not sufficiently strong to create general anesthesia as a sole agent. The interaction when combined with inhaled or intravenous anesthetics is more or less directly additive. It can also be combined with all clinically used hypnotics, analgesics and anesthetics. Apart from its analgesic/anesthetic properties, medicinal nitrous oxide exhibits only very minor effects on autonomic functions such as respiration and circulation. Spontaneous breathing is relatively better preserved when anesthesia is created by the combination of medicinal nitrous oxide and any of the commonly used inhaled anesthetics when compared with anesthesia induced by the potent inhaled anesthetic alone. The cardiovascular variables are also less affected.

The rapid “wash-in” (uptake) and “wash-out” (fast elimination) of medicinal nitrous oxide is well known. Because of this rapid elimination and well-maintained spontaneous respiration, emergence has been shown to be faster in many studies where a modern inhaled halogenated anesthetic has been combined with medicinal nitrous oxide than when that has been used alone.

Medicinal nitrous oxide is relatively inexpensive and certainly far more so than most other commonly-used anesthetics/analgesics.

Taking its clinical features, rapid on-set of action, minimal cardio-respiratory effects and rapid off-set, emergence into account as well as its low cost, medicinal nitrous oxide is an interesting cost-effective choice in modern anesthesia. Improving spontaneous respiration during surgical laryngeal mask anesthetic procedures (lasting an ever-increasing number of days) shortens emergence and brings early recovery, facilitating a rapid patient turnover in the operating theatre.

A long and highly extensive record of medicinal nitrous oxide in clinical use is also worthy of consideration. The contraindications for patients for whom the use of nitrous oxide could cause side effects are well recognized and easily identified. There is scarcely any other drug in use today that has been used so widely and so safely with such a vast number of patients


Medicinal cardio-pulmonary test gases (also called medicinal lung function test gases) are used for in-vivo diagnostic testing to measure either alveolar diffusion capacity in the lung (pulmonary function with CO as the investigative compound) or lung blood flow to give cardiac output (cardiopulmonary function with C2H2 or CO2 as the investigative compound).

The medicinal lung function test gases, which are inhaled, consist of gas mixtures containing a tracer gas. The exhaled gas is analyzed and differences in the concentration of the tracer gas can be used to diagnose different lung diseases

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