515

J. Physiol. (I955) I27, 5I5-524

A CRITICAL EXAMINATION OF THE

DOUGLAS BAG TECHNIQUE*
BY R. J. SHEPHARD
From the Cardiac Department and the Physiology Department,
Guy's Hospital, London, S.E. 1
(Received 30 August 1954)
Although the Douglas bag method of measuring respiratory exchange has been
in routine use for many years, there is little published work concerning the
errors that may arise from diffusion of gas through the fabric and proofing of
the bags.t
In the original description of the method (Douglas, 1911), it was suggested
' each bag should be examined carefully to see that the rate of diffusion through
its walls is negligible'. However, it was found that even with careful selection
of bags some loss of carbon dioxide was apt to occur, and this loss was attributed
to solution of carbon dioxide in the rubber of the proofing (Douglas & Priestley,
1948). There has been no real agreement on the time that elapses before a
significant loss of carbon dioxide occurs. Michaelis & Muller (1942) examined
bags of 1000 1. capacity, and found a measurable decrease of carbon dioxide
concentration in 15 min. On the other hand, Mills (1951), using bags of more
usual size, reported that with physiological mixtures of carbon dioxide there
was a fall in concentration of not more than 0 2-046 % per diem. Siebe-
Gorman (personal communication), in a limited number of experiments with
bags of 30 and 100 1. capacity, observed a change in concentration of inter-
mediate rate amounting to about 0-8 % in the course of a day. The explanation
of these apparently divergent results is that all have been based on estimates
of carbon dioxide concentration alone; to obtain accurate information about
the behaviour of Douglas bags in general, it is necessary to consider other
variables, particularly the volume of gas in the bag and the surface area of the
bag in question.
* The work described in this paper has been submitted to the University of London in part
fulfilment of the requirements for a Ph.D. degree in the Faculty of Science.
t Since completion of this work, Balchum, Hartman, Slonim, Dressler & Ravin (1953) have
described some of the physical factors affecting diffusion from the Douglas bag. Their findings are
in substantial agreement with those reported here.
33-2
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516 R. J. SHEPHARD
The present paper examines some of these variables. It is established on
physical grounds that loss of gas occurs by a process of molecular diffusion.
Diffusion coefficients for each of the respiratory gases are determined, and the
significance of these findings is discussed in relation to the laboratory use of
the Douglas bag.
METHODS
Douglas bags. These were the standard Siebe-Gorman pattern (fabric coated with vulcanized
rubber), with total capacities ranging from 60 to 200 1. Some were of recent purchase, but others
had seen routine service for periods of up to 20 years. A careful preliminary inspection of the bags
was carried out, and those with obvious structural faults were discarded. As a further precaution
against the inclusion of bags with structural faults in this series of experiments, the bags were
filled with air for a period of 24 hr, and those that showed a significant decrease in volume over
this period were also rejected.
Gas analysis. Carbon dioxide concentrations were determined by the standard Haldane gas-
analysis apparatus, gas samples being collected in evacuated sampling tubes of 70 ml. capacity.
Oxygen concentrations were measured with a paramagnetic oxygen analyser kindly loaned by
the British Oxygen Corporation. This apparatus has been described in more detail elsewhere
(Shephard, 1954). For the present purpose it is sufficient to note that oxygen concentrations could
be estimated to 0.1%, involving an error of 1% in measurements of the oxygen diffusion rate.
Gas volume measurements. A number of factors may cause serious inaccuracies in the measure-
ment of gas volumes by the Douglas bag and water-sealed gasmeter, and it is essential to minimize
these sources of errorif an adequate measure of diffusional changes is to be obtained.
There may be leakage at structural faults in the bag, and such changes must be distinguished
from pure diffusion through the substance of the fabric and proofing. However, this factor was
eliminated by the method of selecting the bags used in these experiments.
The correct use of the gasmeter itself is also important. Krogh (1920) and Liljestrand (1918)
have emphasized that to avoid inaccuracies from fluctuations in the water-level and variations in
the gas volume transported per revolution, the meter must be operated at a speed of less than
2 rev/min. In this laboratory, small gas volumes (up to 51.) have been delivered from a spirometer
at this speed, and there has been agreement with the gasmeter reading to within 0.01 1. (that is, to
within the limits of accuracy of the spirometer). However, where larger gas volumes have been
collected in a Douglas bag, a loss of gas has been observed, the magnitude varying with the total
volume of gas passed through the meter (Fig. 1). Thus in experiments where a Douglas bag was
filled via the meter, it was necessary to correct the dial reading for this loss.
With mixtures containing carbon dioxide, there is a further possible error from absorption of
gas in the water-seal of the meter. The volume of water approaches 4 L, and an application of
Henry's law shows that with a 5% mixture of carbon dioxide under laboratory conditions of
temperature and pressure, absorption could be as much as 0-3 1. However, it would seem that this
loss was avoided in the present experiments by saturating the meter with carbon dioxide, since
there was no change of carbon dioxide concentration associated with passage of gas through the
meter, and the loss of gas during the filling of a Douglas bag with a mixture containing 95%
oxygen and 5 % carbon dioxide was closely similar to that found for a comparable initial volume
of air.
The use of gas sampling tubes may also introduce errors of up to 1 1. unless particular care is
taken to measure and control the volume of gas lost in this way (Shephard, 1954). In the present
experiments, three evacuated sampling tubes (total capacity 0-21 L) were used, the first serving to
flush out the side-tubing of the Douglas bag and being discarded for subsequent purposes of
analysis.
Finally, care must be taken to ensure complete emptying of the Douglas bag. The technique
adopted consisted of folding the bags to a standard pattern, and compressing until the meter
indicated that no further gas was being expressed.Michaelis & Muller (1942) have suggested that

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 DOUGLAS BAG TECHNIQUE 517
as an alternative procedure the bags might be allowed to aspirate the gas under investigation at
the beginning of each experiment, a standard correction of 2x5 1. being subtracted from the final
volume measurement. However, this is clearly incorrect, since the elastic properties of individual
bags vary greatly, and the amount aspirated may range from 05 to 5*0 1.

0-4

0
9

03 I

I-
6
0

0.
WI
I
-0-2
to
0
go
I
I
I
I
I
0-1 I
I
I
I
I
I
I

v 10 20 30 40 50 60
Total volume of gas passed through meter (litres ATPS)
Fig. 1. Relationship between loss of gas in meter system and volume of gas passed through gas-
meter: the graph shows the mean and standard error of ten successive estimates of loss at a
given gas volume; seven experiments with different volumes of air, and one experiment with
mixture of 5% carbon dioxide in oxygen. The loss of gas has been expressed in terms of
ambient temperature, pressure saturated with water (ATPS). Regression line fitted by the
method of least squares (P =0.01-0*001).

RESULTS
It is well known that a loss of carbon dioxide may occur if gas mixtures are
stored in the Douglas bag. The amount of this loss bears a close relationship
to the period of storage. Typical results with a bag of 1001. capacity containing
initially 50 1. of 5 % carbon dioxide in oxygen are illustrated in Fig. 2. It is
usually accepted that the loss can be attributed to diffusion of carbon dioxide
through the wall of the Douglas bag, but to establish the truth of this concept
it is necessary that certain additional relationships should be satisfied:
(a) partial pressure gradient-for a given Douglas bag, the gradient at the
bag/air interface should govern the rate of exchange of the gas under con-
sideration; (b) surface area-if bags of similar fabric are compared, the rate of
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518 R. J. SHEPHARD
loss of gas should depend upon the surface area; (c) type of gas-a clearly
defined diffusion coefficient should be applicable to a given fabric and gas, and
in bags of similar design the ratio of the diffusion rates for different gases
should be similar.
20

0~~~~~
,, 1*0/
0 0.5

0
/
0.

I I I I 1 I.
0 10 20 30 40 50 60 70
Time in hours
Fig. 2. Loss of carbon dioxide from Douglas bag: 100 1. Douglas bag containing initially 50 1. of
a 5% mixture of carbon dioxide in oxygen. Note that the bag shows a steady decrease in
carbon dioxide content bearing a close relationship with time.

The influence of partial pressure gradient

To calculate the partial pressure of gases stored in the Douglas bag, it is
necessary to know the excess pressure within the bag.- Measurements were
made quite simply by connecting a water manometer to the side-tubing. It
was found that there was an approximately linear relationship between excess
pressure and total gas content (Table 1). However, unlike the small and fully
inflated bags used on Everest (Pugh, 1953), the excess pressure was low, the
maximum value being about 4 mm H20 with the larger bag, and 13 mm H20
with that of smaller capacity. The pressure required to operate the gasmeter
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 DOUGLAS BAG TECHNIQUE 519
was somewhat higher, averaging 20 mm H20, but the bags were only subjected
to this pressure for a relatively short time. Thus for the purpose of calculating
partial pressures, there is little error in considering the pressure within the bags
as atmospheric.
TABLE 1. Excess pressures in Douglas bag at varying degrees of filling
Bag 061 (60 1. capacity) Bag 101 (100 1. capacity)
A
Vol. of gas Excess Vol. of gas Excess
in bag pressure in bag pressure
(1.) ATPS (mm H20) (1.) ATPS (mm H20)
22-25 3 15-82 2
26-79 4 27-50 3
30*25 6 29-17 3
45*25 8 37*50 3
47-29 6 45-21 3
52-29 8 60-00 4
63-45 13 72-50 4
70-20 13 100*00 4
Alft
su r
Bag 101 /
35 50
50 * / 1" 50
67 90
90
30
44
25F 32
n 20
W
%a

42
d 1s
50
10
50

a I I I I I I I I
6
0 5 20
10 25
15 30 35 40 45 50
Rate of loss of carbon dioxide (ml./hr)
Fig. 3. Relationship between rate of loss of carbon dioxide and average carbon dioxide pressure
within Douglas bag: Douglas bag of 100 1. capacity containing various total volumes of gas
mixtures as shown on graph. Regression line fitted by the method of least squares, with rate
of loss of gas as the dependent variable (P <0*001).

The influence of changes of partial pressure gradient on the rate of loss of

gas was investigated by filling the bags with mixtures containing initially
1-5 % carbon dioxide. For a given bag, it was found that the rate of loss of
carbon dioxide was related directly to the average partial pressure of this gas
within the bag (Fig. 3).
From the theoretical point of view, there are two distinct physical processes
by which loss of gas may occur: unrestricted molecular movement through

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520 R. J. SHEPHARD
apertures of relatively large size, and restricted movement through pores of
approximately molecular dimensions. In his studies of the diffusion of hydro-
gen from airships, Shakespear (1916-17) concluded that the first process was
the more important. However, if diffusion is occurring through defects of this
type, application of the kinetic theory of gaseous movement shows that the
loss of gas should be related to the square root of the mean tension gradient.
The observed direct relationship is in keeping with Graham's law, and this
would suggest that in the Douglas bag loss of gas is occurring through pores of
approximately molecular dimensions.
The influence of surface area
It can be seen from Fig. 3 that the linear relationship between partial
pressure gradient and rate of loss of carbon dioxide has been maintained despite
large variations in the initial gas volume. This suggests that the rate of loss is
independent of the volume of gas within a bag of given capacity. However,
the rate of loss for a given partial pressure gradient varies in bags of differing
total capacity, and it seems probable that this can be related to a difference of
surface area. Thus if the rate of loss per square metre of surface is calculated
(Table 2), it can be seen that this value is very similar in each of the bags
examined.
TABLE 2. Relationship between surface area and rate of loss of carbon dioxide from
Douglas bags each containing initially 5% COi in 02
Total capacity Mean rate of Surface area of Rate of loss/m2
of Douglas bag 1088 of C02 Douglas bag bag surface
(1.) (ml./hr) (m2) (ml./hr/m2)
60 35 0-95 37
100 43 1-41 31
200 85 2-30 37

The influence of type of gas

The diffusion coefficient for carbon dioxide may be calculated from the slope
of the graph in Fig. 3. Expressed in terms of a surface area of 1 m2, the
coefficient is approximately 1 ml./hr/mm partial pressure gradient for each of
the bags examined. It seems probable that the diffusion coefficient is not
greatly influenced by the age of the bag, since the 60 and 100 1. bags were of
comparatively recent purchase, whereas the 200 1. bags had been in routine
use for up to 20 years. In studies with simple rubber membranes, Edwards &
Pickering (1920) found that there was no change in the permeability of the
rubber where the increase in combined sulphur was slight, but when the in-
crease in combined sulphur was greater the rubber became brittle and there
was a decrease in permeability.
To determine the coefficients for oxygen and nitrogen, the bags were filled
with 100 % oxygen, thus giving a pressure gradient of some 560 mm for each
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 DOUGLAS BAG TECHNIQUE 521
gas. It was found that there was a considerable difference between the rate of
loss of oxygen and the rate of gain of nitrogen, the ratio for the two diffusion
rates being approximately 2-4: 1 0 (Fig. 4). At a comparable partial pressure
gradient, the rate of loss of carbon dioxide would be approximately 10 times
the rate for nitrogen. Similar ratios have been observed in earlier studies on
pure rubber membranes (Barrer, 1939) and airship fabrics (Director of Air
Services, 1918-19).
300
551. Bag 101
250

651. 251. tile.

Man
f10n
bgo2001.
401. 21
at ofeah
150d arindigam Ntetht h rti o te wdffsinatsisl2.51.a

100

50A

Fig. 4. Diffusion of oxygen from and nitro-gen into a Douglas bag: typical results obtained with
bag of 100 1. capacity filled initially with various total volumes of 100% oxygen, as indicated
at head of each barin diagram. Note that the ratio of the two diffusion rates is approximately
2-4: 1 0. 0, diffusion rate for nitrogen; *, diffusion rate for oxygen.

Ratios of this order are difficult to interpret in terms of diflusion across a

simple membrane, and it would seem that the gases are dissolving either in the
actual proofing agent or in an aqueous film at the bag/air interface, thereby
altering the effective concentrations of the different gases. The oxygen/nitrogen
ratio can be reconciled with water solubility as a limiting factor, but the rate
of loss of carbon dioxide is too slow to explain on this basis. The solubility of
gases in rubber is rather variable, but the published figures (Ritchie, 1918-19;
Venable & Fuwa, 1922; Daynes, 1920; Barrer, 1939, 1951) indicate a ratio of
solubilities for carbon dioxide, oxygen and nitrogen of the order 10: 2: 1.
Thus the behaviour of the Douglas bag fabric towards these different gases is
best explained in terms of solution in the rubber at the proximal surface,
diffusion through the rubber, and evaporation at the distal surface.

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522 R. J. SHEPHARD

DISCUSSION
The practical application of these findings remains to be considered. Having
established diffusion coefficients for the three principal components of expired
air, it is possible to predict the behaviour of gas mixtures of this type on
storage in a given Douglas bag.
The possible contribution of nitrogen diffusion is small, since this gas has the
lowest diffusion coefficient, and the partial pressure gradient is only a few
4 16

0
3 17
50 0
(U
co
C
0 e
tj
0w
._
c
a.
a
u2 180
0 0
02 C
0 0
(U
L
4.'
c C
0
to R0
0 19 o-
U u

0 20
0 100 200 300 400
Time in hours
Fig. 5. Effect of storage on composition of gas in Douglas bag: the graph illustrates the changes in
concentration of carbon dioxide and oxygen in a typical Douglas bag of 100 1. capacity,
filled to capacity with a gas mixture containing initially 4% carbon dioxide and 16%
oxygen.

mm Hg. At most, the actual amount involved will be about 0-5 ml./hr, and
for the present analysis this change may be neglected. Fig. 5 illustrates the
progressive changes in carbon dioxide and oxygen concentrations in a typical
Douglas bag of 100 1. capacity, filled to capacity, on storage at room tempera-
ture. Assuming initial concentrations of 4 % carbon dioxide and 16 % oxygen,
it can be seen that for the first 100 hr the loss of carbon dioxide exceeds the
gain of oxygen, and there is in consequence a decrease in the total volume of the
bag. Over the next 200 hr, the two diffusion rates are sensibly equal, and the
volume in the bag remains approximately constant. The diffusion of oxygen
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 DOUGLAS BAG TECHNIQUE 523
inwards then begins to exceed the loss of carbon dioxide, and the gas tends to
show a small increase in volume. In this particular instance, the maximal
change in volume is of the order of 1 % of the total initial volume.
Normally, bags are only stored for a matter of 10-15 min, and it might
appear from Fig. 5 that diffusional changes over this period are not important.
It is certainly true that the gain of oxygen is too small to detect by the usual
methods of Haldane gas-analysis, but there are circumstances in which the
loss of carbon dioxide can assume some practical significance. In a typical
respiratory experiment, 401. of expired gas may be collected in a Douglas bag,
and if the total capacity is somewhat larger (say 200 1.) the carbon dioxide
concentration would fall by 0-05 % in 15 min. If the observer is measuring
carbon dioxide output or respiratory quotient, this would affect the accuracy
of his results by as much as 1 %. However, a 1 % error in the estimated
respiratory quotient may be acceptable for the determination of metabolic
rate, since this does not affect the calorific equivalent of the observed oxygen
consumption by more than about 0-3 %. It is clear that the error of all these
measurements is more serious if a smaller volume of expired air is collected, if
bags of larger surface area are employed, or if the bags are stored for longer
periods (as may be the case where technicians prepare gas mixtures for
classwork).
To obtain the optimum results with existing bags, it will be seen that these
should be filled almost to capacity, and if this is not possible it is advisable to
correct for loss of carbon dioxide even when the period of storage is short. The
temperature at which the bags are stored is of comparatively little importance,
since Venable & Fuwa (1922) have shown that at normal room temperature a
change of 100 C alters the solubility of carbon dioxide in rubber by only 10 %.
Provided that the bag is free of structural faults and the rubber shows no signs
of becoming brittle, the age appears to make little difference to the rate of
diffusion.
To improve the gas-retaining properties of the Douglas bag, it should be
designed with a minimum area/volume ratio. Little advantage can be gained
by increasing the thickness of the rubber film, since the factor limiting diffusion
appears to be the solubility of the different gases in the proofing agent. The
long-term answer to the problem of diffusion appears to lie rather in a search
for a proofing agent with the durability and elasticity of rubber, but having
a much smaller solubility coefficient with respect to the respiratory gases.
SUMMARY
1. Errors with the Douglas bag technique are of two types. There may be a
gross loss of gas contents due to faults of technique, and methods of minimizing
such a loss are described. However, there is also a selective loss of carbon
dioxide that is more difficult to overcome.
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524 R. J. SHEPHARD
2. The loss of carbon dioxide can be attributed to diffusion through pores of
molecular size, since the rate of loss bears a direct relationship to both partial
pressure gradient and surface area. Other gases also show characteristic rates
of exchange across the bag/air interface.
3. Diffusion coefficients have been determined for carbon dioxide, oxygen
and nitrogen. The observed ratio of these coefficients (10: 2: 1) is compatible
with rubber solubility as the limiting factor governing diffusion of gases across
this membrane.
4. To minimize diffusional errors, Douglas bags should be filled almost to
capacity. If this is not possible, within 15 miin the loss of carbon dioxide may
be sufficient to produce a 1 % error in the estimated carbon dioxide output,
and a correction should be applied even for short periods of storage.
5. Little improvement can be obtained by an alteration in the design of the
bag or the conditions of storage, since the principal difficulty is the solubility
coefficient of rubber with respect to the respiratory gases. The ultimate solu-
tion to the problem lies rather in a search for a more satisfactory proofing agent.
REFERENCES
BALcHUM, 0. J., HARTMAN, S. A., SLONIM, N. B., DRESSLER, S. H. & RAvIN, A. (1953). The
permeability of the Douglas-type bag to respiratory gases. J. Lab. clin. Med. 41, 268-80.
BARRER, R. M. (1939). Permeation, diffusion, and solution of gases in organic polymers. Trans.
Faraday Soc. 35, 628-643.
BARRER, R. M. (1951). Diffusion in and through Solids, 2nd imp. Cambridge University Press.
DAYNES, H. A. (1920). The process of diffusion through a rubber membrane. Proc. Roy. Soc. A,
97, 286-307.
DIRECTOR OF Am SERVICES (1918-19). The permeability of airship fabrics. Part I. Tech. Rep.
adv. Comm. aero., Lond., 3, 1316-1337.
DOuGLAS, C. G. (1911). A method for determining the total respiratory exchange in man. J.
Physiol. 42, 17-18P.
DOuGLAS, C. G. & PRIESTLEY, J. G. (1948). Human Physiology: a Practical Cour8e, 3rd ed., p. 58.
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EDWARDS, J. & PICKERING, S. (1920). Permeability of rubber to gases. Sci. Pap. U.S. Bur. Stand.
16, 327-362.
KROGH, A. (1920). The calibration, accuracy, and use of gasmeters. Biochem. J. 14, 282-289.
LIWESTRAND, G. (1918). Untersuchungen iiber die Atmungsarbeit. Skand. Arch. Physiol. 35,
199-293.
MICILELIS, H. & MULLER, E. A. (1942). Die Bedeutung des alveolaren CO2 Druckes fur die
Bestimmung des auf die Atmung entfallenden Energieverbrauches. Arbeitsphysiologie, 12,
85-91.
MILLS, J. N. (1951). The use of an infra-red analyser in testing the properties of Douglas bags.
J. Physiol. 116, 22-23P.
PUGH, L. G. C. E. (1953). Technique for measuring respiratory exchanges on Everest, 1953.
J. Physiol. 123, 25P.
RITCHIE, A. D. (1918-19). The permeability of airship fabrics. Part II Tech. Rep. adv. Comm.
aero., Lond., 3, 1338-1363.
SHAKESPEAR, G. A. (1916-17). A new permeability tester for balloon fabrics. Tech. Rep. adv.
Comm. aero., Lond., 2, 579-583.
SHEPHARD, R. J. (1954). Ph.D. Thesis, University of London.
VENABLE, C. S. & FuWA, T. (1922). The solubility of gases in rubber and rubber stock, and effect
of solubility on penetrability. J. industr. Engng Chem. 14, 139-142.

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