Gases for Medical Applications

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Gases in the Service of Medicine ��

Gases have long been an

established aid to the medical

profession - and year after

year, researchers and techni-

cians continue to discover

new, successful applications.

Gases assist with respiration

and anaesthesia, allow special-

ists to study the functioning of

the lungs and cardiovascular

system, are essential tools in

diagnosis and cryosurgery,

and - when they meet the

necessary specifications - can

also be used to operate and

calibrate medical measuring

apparatus. Liquid nitrogen and

helium have already proved

their worth in the field of MR

imaging.

In other words:

Gases are an essential part of

modern medicine.

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This brochure provides thereader with an overview of themany medical applications forgases of various kinds.

� Gases for respiration

� Heimox® (oxygen therapy)

� Supplying gas in hospitals

� Gases used in anaesthesiology

� Supplying coolants for MR imaging

� Gases for the clinical laboratory

� Surgery, medicinal baths,cryomedicine and gases formedical lasers

Gases for diagnostics (e.g. forlung function tests, respiratorygas and blood gas analysis)

For general laboratory use:Gases in small containers andgas handling equipment

Gases for Respiration �

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Oxygen and various gas mixtures areused when the body’s gas regime is dis-rupted. When the body is subjected tounusual stresses or respiration is weakas a result of inhaling anaesthetics orother substances that have a paralysingeffect on the respiratory centre, the useof pure oxygen is indicated.

The Carbogen gas mixture (5% CO2,balance O2) is used to assist and stimulate respiratory activity.

Carbogen is just one example of thewide and varied range of gas mixturesthat are available and can be supplied tosupport the respiratory function. Optionsrange from simple mixtures such as“synthetic air” to complex mixtures thatinclude stable isotopes. All gas mixturesare manufactured to very high standardsof precision and reliability using state-of-the-art technology, and the entire pro-duction chain is subject to a stringentquality assurance process.

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Water- Exterior Length Total weight Filling pressure Contentscapacity dia. incl. cap incl. contents at 15 °C(litres) (mm) (mm) (kg approx.) (bar approx.) (m3)

2 100 490 6 200 0.410 140 970 17 200 250 229 1640 79 200 10

Water- Dimensions Total weight Filling pressure Contentscapacity L x W x H incl. contents at 15 °C

(litres) (mm) (kg approx.) (bar approx.) (m3)

600 965 x 760 x 1842 1180 200 120

● Oxygen for medical purposes (DAB/Ph.Eur.)Oxygen for medical purposes is supplied in specially prepared steel cylinders (from a separate cylinder store) with chromium-plated cylinder valves.

Containers: steel cylinders

Cylinder bundle consisting of 12 upright 50-litre cylinders

Oxygen can also be supplied as cryogenic liquid by road tanker for the production ofoxygen for medical purposes (DAB/Ph.Eur.).

Water- Exterior Length Total weight Filling pressure Contentscapacity dia. incl. cap incl. contents at 15 °C(litres) (mm) (mm) (kg approx.) (bar approx.) (m3)

10 140 970 17 188 250 229 1640 79 188 10

● Carbogen (5 % CO2, balance O2)

Containers: steel cylinders

Water- Exterior Length Total weight Filling pressure Contentscapacity dia. incl. cap incl. contents at 15 °C(litres) (mm) (mm) (kg approx.) (bar approx.) (m3)

10 140 970 17 200 250 229 1640 79 200 10

● e.g., helium-oxygen mixture (20 % O2, balance He)

Containers: steel cylinders

External circumstances may create anatmosphere that even represents ahazard to healthy people. With the helpof breathing equipment – either suppliedwith gas from a central store or fittedwith a portable supply of gas in cylinders– it can be ensured that each individualreceives the right kind of “air”.

See also our remarks in the chapter onHEIMOX®.

The composition of artificial respiratorygases can be adjusted to compensatefor unusual circumstances or require-ments. Normal respirators work withcompressed air or “synthetic air”, a mix-ture composed of 20 – 21% oxygen and79 – 80% nitrogen.

Whenever artificial respiration is neces-sary under increased absolute pressure– consequently with the risk that thepressure might suddenly drop – thenitrogen in the respiratory air is replacedby helium (e.g. in deep-sea diving appa-ratus, undersea laboratories, decom-pression chambers).

Other gas mixture options are describedin the section on “Gases forDiagnostics”.

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Water- Exterior Length Total weight Filling pressure Contentscapacity dia. incl. cap incl. contents at 15 °C(litres) (mm) (mm) (kg approx.) (bar approx.) (m3)

10 140 970 17 200 250 229 1640 79 200 10

Water- Dimensions Total weight Filling pressure Contentscapacity L x W x H incl. contents at 15 °C

(litres) (mm) (kg approx.) (bar approx.) (m3)

600 965 x 760 x 1842 1180 200 120

● Synthetic air (20 % O2, balance N2)

Containers: steel cylinders

Cylinder bundle consisting of 12 upright 50-litre cylinders

Water- Exterior Length Total weight Filling pressure Contentscapacity dia. incl. cap incl. contents at 15 °C(litres) (mm) (mm) (kg approx.) (bar approx.) (m3)

10 140 970 17 200 250 229 1640 79 200 10

● Compressed air according to DIN 3188

Containers: steel cylinders

● Other respiratory gas mixtures are produced to order, according to therequirements of the specific application. For example, the mixture of respiratorygases used by divers operating at great depths must be adjusted with care. In thiscase, the nitrogen is partially or completely replaced by helium.

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Heimox®

All You Need for Oxygenation and Ventilation �

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The HEIMOX®- mobil

The HEIMOX®- mobil liquid-oxygensystem consists of two elements: areservoir container that can also be usedas a stationary supply, and a lightweightportable container, which is available intwo versions with different capacities.Integrated tubular heat exchangers andcontrol fittings convert the liquid oxygeninto its gaseous state and warm it toapproximately room temperature forinhalation by the patient. A flow regulatorthen dispenses it at a rate between 0.12and 15 litres per minute, depending onthe model.

Companion® 318

The Companion® 318 is designed totreat insomnia arising from obstructionsof the airways. It uses the nasal contin-uous air-passage overpressure method(nCPAP) of respiration. This involvespassing filtered ambient air through atwo-stage fan to generate a pressurethat can be regulated between 3 and 18 cm w.g. The system supplying air tothe patient - which normally consists ofan air hose with a nosepad fitting andnosepad (ADAM® system) or an air hosewith mask – is connected to the front ofthe device. An optional humidifier can beused to humidify the air if required. Theintegrated delay mechanism means thatthe pressure can be lowered at pre-defined intervals, e.g. while the patient isgoing to sleep.

Please ask for our brochures on “Long-term oxygen therapy using the HEIMOX® SKa oxygen concentrator”and “An oxygen source for long-termtherapy of in-patients and out-patients”.

HEIMOX® Ska

The HEIMOX® Ska oxygen concentratoris an electrically powered, electronicallycontrolled device for producing oxygenfrom the ambient air. It employs the„pressure swing adsorption“ method toaccomplish this, channelling the air alter-nately through two containers filled withnitrogen-selective molecular sieve mate-rial (zeolite). The oxygen concentration iscontinuously monitored, and a lamplights up to alert the patient if it falls

below the required level of 85 % O2. Thebuilt-in flow regulator provides the pa-tient with oxygen at a stepless rate be-tween 0 and 5 litres per minute.

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Linde Supplying Gas in Hospitals �

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In nearly all situations, it is just asvital for hospitals to have continuousavailability of gases as it is for themedical personnel to be preparedand ready for action at all times. Tomake sure that gases are deliveredwhere they are needed, we offer twodistinct systems:

Central gas supply

Nowadays, almost every hospital has acentral gas supply installation. Through asystem of pipes that permeates the entire complex of buildings, almost everyroom can be supplied with essentialgases:

– Oxygen– Nitrous oxide– Compressed air– Synthetic air

The system of pipes is fed by a centralunit in the basement (usually with someform of access for road tankers).

There are a number of variations on thistype of supply:

– Individual cylinders (where the gasrequirement is very low)

– Combinations of 624 single cylindersto form cylinder batteries

– Cylinder bundles (only available foroxygen and synthetic air)

– Storage tanks for oxygen (also forsynthetic air if combined with nitrogen) and nitrous oxide

Supply by individual cylinders

A central gas supply is only practicablein the case of the gases listed above,which are constantly required at variouspoints of use.

Individual cylinders are always availablefor use where the relevant gases (e.g.gas mixtures, instrumentation gases) arerequired in small quantities. Also, itmakes sense to have individual cylindersof oxygen, nitrous oxide, compressed airand synthetic air available for use atshort notice, e.g. in emergency situa-tions, or for use with mobile diagnostic,therapeutic or anaesthetic apparatus.

If a particular kind of gas is required atseveral points (e.g. in a central labora-tory), then we recommend that you consider installing a central gas supply.

Benefits

– Centralisation, because installation ishoused in hospital supply building

– Constant availability at point of consumption

– Takes the pressure off staff: No needto carry around steel cylinders,reduction of associated risks andsources of error

– Installation can be connected to theemergency power supply

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Gases Used in Anaestetics �

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* The given contents relates to containers with a test pressure of 250 bar.** Cylinder without foot or cap, only for nitrous oxide (DAB/Ph.Eur.) for medical applications;

supplied in suitable packaging. The size of cylinder is appropriate for use in medical apparatus.

In the case of nitrous oxide, when larger volumes of gas are needed it is advisable toswitch to a gas supply based on liquefied gases supplied from a tank facility.

Nitrous oxide is a gas liquefied under pressure. A steel cylinder filled completely withnitrous oxide consequently always contains both liquid nitrous oxide and a gascushion on top of the liquid. The pressure exerted by this cushion of gas (= thevapour pressure of nitrous oxide) can be measured, i.e. the pressure shown on apressure gauge remains constant if the temperature of the cylinder does not change,even when gas is being withdrawn from the cylinder. (The withdrawn gas is replacedby gas evaporating from the liquid phase.)

● Xenon

This rare gas (Xe) both produces a more powerful anaesthetic effect and is more fat-soluble than nitrous oxide. Using modern closed-circuit anaesthetic apparatus,this expensive gas can be reclaimed and put back into circulation again. Xenon iscurrently undergoing clinical trials as an inhalable anaesthetic.

PropertiesXenon is a colourless, odourless rare gas that is present in the air in amounts of0.08 vpm (= 0.000008 % by vol.). It is neither flammable nor toxic.

Water Exterior Length Total weight Vapour pressure Contentscapacity dia. incl. cap incl. contents at 20 °C(liters) (mm) mm) (kg approx.) (bar approx.) (kg)

2 ** 100 420 ** 4.3 50.8 1.5 *3 ** 100 580 ** 6.1 50.8 2.25 *

10 140 970 21.5 50.8 7.5 *40 204 1630 78 50.8 29.6

● Nitrous oxide (DAB/Ph.Eur.)Containers: steel cylinders

The purpose of anaesthetic agents isto induce a condition in the patientwhereby sensations of pain and con-sequently muscle contractions, andhence also defensive reactions, aremassively attenuated or even neu-tralised altogether. If the patient alsoloses consciousness, this is termedgeneral anaesthesia or narcosis.

Nitrous oxide(DAB/Ph.Eur.)

A gaseous anaesthetic is added to therespiratory gas (oxygen, air). Modernanaesthetic apparatus allows very pre-cise and easily controllable metering ofthe anaesthetic gas or vapour. At thesame time, the oxygen and carbon di-oxide content of the respiratory gas iscontinuously monitored.

Of the various gases (or vapours fromvolatile liquids) once used for inhalationanaesthesia (including nitrous oxide,cyclopropane, chloroform, and ether),only nitrous oxide (also known as laugh-ing gas, N2O) is still in regular use.

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Liquid Heliumfor MR Imaging �

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Principle of MR imaging

Alongside spectrometric applications inchemistry and solid-state physics,magnetic resonance imaging (MRI) hasbecome a well-established tool for med-ical diagnosis.

It can be used to build up layered pic-tures of the human body, and also - bymeans of in vivo spectroscopy - to ob-serve metabolic processes in living tis-sue. In order to generate the images orspectra, the signals emitted by specificchemical elements as a result of themagnetic behaviour of their atomic nuclei are analysed.

Building design

During the early planning stages of aproject, it is essential to take a verydetailed look at the architectural andlogistical aspects of supplying coolant tothe MR installation. Experienced Lindegas specialists are always available togive appropriate expert advice. Whenplanning the installation of an MRI unit,intensive discussion between the futureoperator, the supplier of the installation,the architect or contractor and the gasspecialist are a sine qua non.

Talk to us - Linde has the liquid helium,the expertise and the service.

Unlike other imaging procedures usedfor diagnosis, MRI allows high-contrastimages of soft tissue to be generatedwithout the use of high-energy ionisingrays. The primary tools used to generatethe external stationary magnetic field aresuperconducting magnets. These arecapable of generating very powerfulhomogeneous magnetic fields, a pre-requisite for high-contrast images.

„Superconductivity“ is the complete dis-appearance of electrical resistance in asubstance. This phenomenon onlyoccurs below the transition temperaturespecific to each material. Niobium-titani-um alloy, which is used for the coil of asuperconducting magnet, has a tran-sition temperature of -263.7 °C. The onlycryogenic gas capable of generatingsuch extremely low temperatures isliquid helium. The coil is immersed in aliquid helium bath at a temperature of -268.9 °C (4.22K), whereby a certainamount of liquid helium evaporates andhas to be replaced.

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Gases for the Clinical Laboratory �

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Gases and gas mixtures are not justrequired for diagnosis and anaesthe-sia. They also provide essential as-sistance to clinical researchers andresearch laboratories.

Based on many years of experience inour own laboratory, from the outset Lin-de was able to take full account of thestringent requirements for gas analysisinstrumentation. High-quality instrumen-tation gases and an appropriate gassupply are key prerequisites for undis-rupted, reliable analysis using ultra-sen-sitive measuring apparatus.

The following applications are typical ofgas usage in a clinical laboratory:

Flame photometry

This analytical procedure, popular in clin-ical sectors, is used to capture the quantity and quality of traces of alkaliand alkaline earths such as sodium (Na),potassium (K), lithium (Li). Depending onwhat exactly needs to be measured,various flame temperatures are used toexcite different atoms.

All the fuel gases required to producethe flame are available as part of Linde’sspecialty gas range:

– Methane 2.5, 2.7– Hydrogen 3.8, 5.0– Propane 2.5– Acetylene for flame photometry– Acetylene (solvent-free)– Synthetic air

(20% vol. O2, balance N2)– Oxygen

Atomic absorption spectrometry (AAS)

AAS is a modified form of flame photo-metry. The radiation from an element-specific spectral light source is directedthrough the sample, which has been

required pure gases and gas mixturesgases can be supplied by Linde ex-stock, including:

● Carrier gases

These are used, for example, to trans-port the sample being analysed throughthe separation column of a gas chroma-tograph into the downstream detectorsystem.

● Zero gases

These contain the calibration componentto be measured in a concentration that isbelow the level of detection of the meas-uring systems being employed. They areused to set the zero point in gas ana-lysers, and as a gas that is free of thecomponent to be measured, for purging.

thermally dissociated into atoms. Theweakening of the radiation as a result ofthe absorbing atoms is being measured.This is the method used for quantitativeand qualitative analysis of a variety ofmetals, such as copper (Cu), zinc (Zn),magnesium (Mg), calcium (Ca), cadmium(C) and mercury (Hg).

A wide variety of fuel gas combinationscan be used to produce the optimal flame temperature in these cases:

– Acetylene for flame photometry/synthetic air

– Acetylene for flame photometry/nitrous oxide 2.5(not for medical purposes)

– Propane 2.5/synthetic airArgon for spectrometry/hydrogen 5.0/oxygen

– Hydrogen 5.0/synthetic air

For “graphite-tube” AAS, argon is mostwidely used as an inert and purge gas toprevent combustion of the graphite tube.For this and all other applications, the

Surgery, Medicinal Baths,Cryomedicine andGases for Medical Lasers �

Carbon dioxide in surgery andmedicinal baths

Minimally invasive surgery is an integralpart of modern medicine. And insuffla-tion with carbon dioxide makes endo-scopic procedures substantially easier toperform.

In baths, carbon dioxide creates a sen-sation of warmth and acts as a vasodi-lator for the skin by stimulating its heatreceptors.

Cryomedicine

Thanks to progress in low-temperaturetechniques, cryomedicine has becomean established medical technique.

This technique exploits the effects ofexposing cells and tissue to cryogenicliquid nitrogen at the extremely low temperature of -196 °C.

Application of very low temperaturesperforms two important tasks:– Cryoconservation e.g. of cells and

tissues– Cryosurgery e.g. deliberate des-

truction of unhealthy tissue

Other applications are in cryotherapy.Here, a cold gas mixture produced fromcryogenic liquid nitrogen is used as atherapeutic aid.

Supply

Consumers of liquid nitrogen need acost-effective supply that is appropriateto their needs. Linde has the rightsystem to meet every requirement. Smallquantities (of between 5 and 300 litres)are delivered by nitrogen servicevehicles. When larger quantities arerequired, Linde installs a vacuum-insulat-ed storage tank at the customer’s pre-mises, which is filled with cryogenicliquid gas supplied by road tanker.

Gases for medical lasers

Various gas mixtures are used for medi-cal lasers. CO2 and excimer lasers haveemerged as new surgical tools inmodern medicine.

Pure gases and gas mixtures in standardand custom formulations can be sup-plied in LASPUR® purities.

If you have any questions relating to deli-very options, gas supply systems, tech-nical specifications, gas properties orsafety procedures, Linde would be pleased to provide you with detailed in-formation.

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Water Exterior Length Total weight Vapour pressure Contentscapacity dia. incl. cap incl. contents at 20 °C(liters) (mm) mm) (kg approx.) (bar approx.) (kg)

2 100 490 6.8 57.29 1.58 140 805 16.5 57.29 6

13 204 720 28.0 57.29 10 27 204 1260 58.0 57.29 2030 204 1700 80.0 57.29 30

● Carbon dioxide (DAB/Ph.Eur.) for medical purposes (CO2 med.)Carbon dioxide for medical purposes is supplied in specially prepared steel cylinders(from a separate cylinder stock) with chromium-plated cylinder valves.

Containers: steel cylinders

11Liquid nitrogen delivery service

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Gases for Diagnostics

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● Calibration gas mixtures

Calibration gas mixtures are high-pre-cision gas mixtures used to calibratemeasuring equipment. They also play animportant role in various processes andin experimental research, whenever mix-tures with precisely defined and preciselymeasured compositions are required.

Linde now offers calibration gas mixturescontaining any of over 150 differentgases and vapours as calibration com-ponents. And we are continually extend-ing the list based on ongoing develop-ment work and our efforts to satisfy ourcustomers’ requirements. Whether ornot it is feasible to supply appropriatecalibration gas mixtures has to be de-cided on the merits of each individualcase. Here users can benefit from ourmany years of experience.

Calibration gas mixtures are used inmedicine primarily for:

– Calibration of measuring apparatus inlaboratories; for example, to calibrategas analysers that run on variousphysical or physico-chemical principles.

– Creation of precisely defined atmos-pheres in order to test gas alarmsystems.

Delivery of customised formulations

Gas mixtures consisting of oxygen, helium, xenon or nitrogen as the balancegas, plus carbon dioxide, carbon mon-oxide, stable carbon monoxide isotope(C18O), nitrogen monoxide, oxygen, helium, argon, xenon or sulphur hexa-fluoride as the calibration component.

Examples of custom formulations arexenon/oxygen mixtures that play a roleas contrast media in computer tomogra-phy, and the nitrogen monoxide/nitrogenmixtures used in NO therapy.

Typical Applications

● Blood gas/respiratory gas analysis

High-precision gas mixtures are used tomonitor the acid/base and blood gasstatus (pH value, partial pressure of O2

and CO2) and to measure the composi-tion of inhaled and exhaled air. One oftwo methods is commonly used to takethese measurements:

– Equilibration, that is, saturation of theblood sample with CO2 gas mixtures,followed by a measurement

– Direct measurement of the sample inquestion

● Gases for lung functiontests

Lung functions tests are primarily usedto measure static lung function values(functional capacity, ability to work) bothin healthy individuals and in cases ofrespiratory infection or disease.

Gas mixtures are used in spirometry,usually with a proportion of some raregas such as helium which the body can-not easily resorb. In order to measurestatic lung function values, e.g. diffusioncapacity using the single-breath method,gas mixtures containing CO and He arepredominantly used.

Other available standard mixturesO2/He, O2/He/N2 mixtures.

CO2 O2 N2 Synth. air Description 20 % O2, balance N2

2 % 2 % Balance „E 1 gas“ 5 % 12 % Balance „Low gas“ 5 % 20 % Balance 6 % 12 % Balance „E 2 gas“4 % Balance5 % Balance

10 % Balance „High gas“15 % Balance

Examples of standardised gas mixturesAvailable ex-stock

CO He CO2 O2 N2 Synth. air(20 % O2, balance N2)

0,2 % 5 % Balance 0,2 % 8 % Balance 0,25 % 18 % Balance0,27 % 9,3 % Balance

20,9 % Balance5 % 15,9 % Balance

Synth. air (20 % O2, balance N2)

Examples of standardised gas mixturesAvailable ex-stock

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For General Laboratory Use

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Gases in small containers

For many applications, large gas cylin-ders are too cumbersome to handle.Other circumstances, such as low ormerely sporadic gas requirement, safetyconsiderations, technical requirementsand so on, may also call for more con-venient forms of gas supply.

Linde’s range of “gases in small con-tainers” is able to meet every kind of gassupply requirement whenever low con-tainer weight or very small quantities ofgas are needed.

The following types are available:

Linde minican® pressure cans aremade out of aluminium and have a testoverpressure of 18 bar. Typical applica-tions range from ambient air monitoringand process control to gas chromato-graphy and medicine. For all the aboveapplications, a wide variety of puregases, calibration gas mixtures andstandard gas mixtures are available inminican® pressure cans. For with-drawing the gas, a proprietary range offittings is available that can be used onall minican® products.

Gas handling equipment

When pure gases, precision calibrationgas mixtures and other gas mixtures aretransferred, it is much more importantthat their purity and composition bemaintained when the gas is withdrawnfrom the cylinders and distributed to theactual point of use than in the case ofindustrial gases. That is why Linde offersthe right equipment for each and everyapplication, from standard regulating valves to specially customised supplysystems.

Regulating valves are used to with-draw gases without pressure control.They can be set to maintain a given gasflow rate. In closed systems, they can beused to maintain a pressure up to thelevel of the cylinder pressure.

Pressure regulators are used to re-duce the pressure of compressed gasfrom high pressure down to a constant,lower withdrawal pressure.

Gas supply systems for general labo-ratory use etc.: the required gas typeand purity depend upon the application.This must also serve as the basis forspecifying the gas supply system. Ourengineers specify the type and quality ofthe equipment in such a way as to opti-mise safety and cost efficiency whilesatisfying the specific requirements ofthe application at hand.

Linde small steel cylinders are high-pressure steel containers for high-puritygases. As they have a test overpressureof 300 bar, the containers have a largecontents. Gas is withdrawn using stan-dard fittings of the type also used onhigh-pressure cylinders.

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Linde Representatives Worldwide

Australia:Linde Gas Pty. Ltd.74–78 Seville StreetAUS-Fairfield, N.S.W. 2165Tel.: (02) 979 42-245Fax: (02) 979 42-265Austria:Linde Gas GmbH & Co. KGWaschenbergerstraße 13A-4651 Stadl-PauraTel.: (0 72 45) 2 16 00Fax: (0 72 45) 2 16 16Belgium:Hoek Loos N.V.Tunnelweg 7B-2845 NielTel.: (0 3) 8 44 25 28Fax: (0 3) 8 44 31 43China:Linde Gas Xiamen Ltd.Hualian Electronic Bldg., 2nd FloorFuxia Road, Torch Hi-tech District361006 XiamenTel.: (0592) 562 39 90Fax: (0592) 562 39 91Croatia:Linde Plin d.o.o.Mahicno bbHR-47286 Karlovac MahicnoTel.: (047) 65 11 12Fax: (047) 65 15 60Czech Republic:Linde Technoplyn a.s.U Technoplynu 1324CR-19800 Praha 9Tel.: (02) 70 06 111Fax: (02) 70 10 15France:Linde Gaz Industriels S.A.R.L.174, Avenue Jean JaurèsF-69007 LyonTel.: (04) 472 76 76 76Fax: (04) 472 76 76 99Greece:Linde Hellas E.P.E.Syngrou Avenue 228GR-17672 Athen-KallitheaTel.: (01) 988 95 99Fax: (01) 985 05 32Hong Kong:Linde Gas Ltd.Room 2601 Sino Plaza256–257 Gloucester RoadCauseway BayHongkongTel.: (02) 25 73 03 78Fax: (02) 28 38 41 15

Hungary:Linde Gáz Magyarország RTIllatos u. 9–11H-1097 BudapestTel.: (01) 2 82 92 82Fax: (01) 2 82 92 81Italy:Linde Caracciolossigeno S.r.l.Via Guido Rossa, 3I-20010 Arluno (Mi)Tel.: (02) 90 39 95-1Fax: (02) 90 39 95-99Malaysia:Linde Industrial Gases Sdn. Bhd.7th Floor, Wisman BudimanPersiaran Raja Chulan50200 Kuala LumpurTel.: (03) 2 38 92 00Fax: (03) 2 38 93 00Netherlands:Hoek LoosPostbus 78NL-3100 AB SchiedamTel.: (010) 24 61-616Fax: (010) 24 61-600Poland:Linde Gaz Polska Sp.z o.o.ul. Piastowska 44cPL-30070 KrakówTel.: (0 12) 23 84 42Fax: (0 12) 23 84 30Portugal:Linde Sogás, Lda.Avenida Infante D. Henrique Lt. 21Cabo RuivoP-1800 LisboaTel.: (0 11) 8 31 04 20Fax: (0 11) 8 59 13 29Romania:LINDE-UMT-GAZ S.R.L.Str. Avram Imbroane 91900 TimisoaraTel.: (056) 20 13 48Fax: (056) 22 56 08Singapore:Linde Gas Singapore Pte. Ltd.74 Kian Teck RoadJurong Industrial EstateSingapore 628 800Tel.: (065) 2 61 64 66Fax: (065) 2 64 01 98Slovak Republic:Linde Technické Plyny K.S.Racianska 71SR-83259 BratislavaTel.: (07) 25 22 02Fax: (07) 25 37 33

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Slovenia:Linde Plin d.o.o.Bukovzlak 65/bp.p. 153SLO-3001 CeljeTel.: (063) 411-777Fax: (063) 411-834Spain:Abelló Linde, S.A.Calle Bailén, 105E-08009 BarcelonaTel.: (03) 2 07 30 11Fax: (03) 2 07 57 64Switzerland:PanGasPostfachCH-6002 LuzernTel.: (0 41) 3 19 95 00Fax: (0 41) 3 19 95 15United Kingdom:Linde Gas UK Ltd.Pipers RoadPark Farm SouthRedditchWorcestershire B 98 OHUTel.: (015 27) 51 72 77Fax: (015 27) 51 65 60USA:Holox Ltd.1500 Indian Trail RoadNorcross, GA 30083Tel.: (0770) 9 25 46 40Fax: (0770) 9 25 49 66

Other countries:Linde AGIndustrial Gases DivisionExport Head OfficeSeitnerstraße 70D-82049 HöllriegelskreuthTel.: (0 89) 74 46-0Fax: (0 89) 74 46-1490

LINDE AGIndustrial Gases DivisionSeitnerstraße 70D-82049 HöllriegelskreuthPhone: (089) 7446-0, Fax: (089) 7446-1230