Drager Apollo

Asset Type

Anesthesia Machine

Manufacturer

Drager

Model

Apollo

What This Guide Helps With

This guide helps troubleshoot a CIRCUIT LEAK alarm on a Drager Apollo anesthesia machine when a leak is detected in the patient circle system. A circuit leak can reduce delivered ventilation, affect tidal volume, interfere with pressure delivery, and compromise anesthetic gas delivery.

Step-by-Step Troubleshooting

1. Ensure Patient Safety First

• If the alarm occurs during patient use, notify anesthesia staff immediately.
• Have clinical staff assess ventilation, oxygenation, airway pressure, and manual ventilation needs.
• Do not continue relying on the anesthesia machine if ventilation is unstable or the leak cannot be quickly corrected.
• Use manual ventilation or another anesthesia machine if clinically required.

Expected outcome: The patient is protected from inadequate ventilation or gas delivery.

Why it matters: A patient circle system leak can prevent the anesthesia machine from delivering or maintaining the intended volume, pressure, or gas mixture.

2. Verify the Reported Alarm and Behavior

• Confirm the displayed alarm is CIRCUIT LEAK.
• Observe whether the alarm appears during startup leak test, manual ventilation, mechanical ventilation, after circuit change, after patient connection, or intermittently during setup or use.
• Check for low delivered tidal volume, low airway pressure, abnormal bellows or piston behavior, audible hissing, difficulty maintaining pressure, or repeated low minute volume alarms.

Expected outcome: The CIRCUIT LEAK alarm is confirmed and the leak behavior is clearly observed.

Why it matters: This confirms a true patient circle leak condition instead of a one-time setup issue or incorrect alarm report.

3. Remove From Patient Use if the Leak Cannot Be Immediately Corrected

• If the leak persists during active use, have clinical staff transfer ventilation support to a safe alternative.
• Remove the anesthesia machine from patient use if the leak affects ventilation or cannot be corrected at the bedside.

Expected outcome: Clinical care continues without relying on a leaking breathing system.

Why it matters: A persistent circuit leak can create unsafe ventilation and anesthetic delivery conditions.

4. Check the Patient Breathing Circuit

• Inspect the breathing circuit tubing from the inspiratory and expiratory ports to the patient connection.
• Look for loose hose connections, cracked tubing, disconnected circuit limbs, incorrectly seated breathing hoses, a damaged Y-piece, loose elbows, or loose adapters.
• Reconnect or replace the circuit if damage or loose connections are found.

Expected outcome: The breathing circuit is fully connected and free of obvious leaks or damage.

Why it matters: The patient circuit is the most common and easiest leak source to verify before suspecting the machine.

5. Check the Tube or Airway Connection

• If the machine was connected to a patient or test lung, check the tube or airway connection area.
• Look for a loose connection at the endotracheal tube or LMA, loose elbow, disconnected sample line adapter, damaged connector, cuff-related leak, or poor seal at the test lung or breathing bag connection.

Expected outcome: The patient-side connection is secure and not allowing gas to escape.

Why it matters: A leak near the airway or test lung may appear as a patient circle system leak even when the machine itself is functioning correctly.

6. Check the Breathing Filter or HME

• Inspect the breathing filter, HME, or microbial filter in the circuit.
• Check for loose filter connection, cracked housing, missing gasket, poor seal, angled installation, excessive moisture, obstruction, or incorrect adapter stack.
• Replace the filter if it is damaged, loose, contaminated, or questionable.

Expected outcome: The filter is correctly installed and not leaking.

Why it matters: Filters are frequently changed between patients and can cause leaks if not fully seated or if the housing is cracked.

7. Check All Adapters and Accessory Connections

• Inspect all added accessories in the breathing circuit.
• Check CO2 sampling adapters, inline suction adapters, nebulizer adapters, circuit extensions, elbows, dead-space adapters, test lung adapters, and bag connections.
• Remove unnecessary adapters and reconnect the simplest safe circuit setup.

Expected outcome: The circuit is simplified and all remaining connections are secure.

Why it matters: Every added adapter creates another possible leak point.

8. Check the Breathing Bag and Manual Ventilation Path

• Inspect the breathing bag and bag arm connection.
• Check for a cracked or torn breathing bag, loose bag connection, bag not fully seated, incorrect APL valve setup for the test condition, or leak during manual bag pressurization.
• Replace the breathing bag if damage is found.

Expected outcome: The manual ventilation path holds pressure without obvious leakage.

Why it matters: A leak in the manual breathing path may be interpreted as a circle system leak depending on mode and setup.

9. Check the CO2 Absorber Canister and Breathing System Seating

• Confirm the absorber canister is fully locked in place.
• Check that the canister seal is clean and undamaged.
• Look for a loose, misaligned, or poorly seated absorber canister.
• Remove granules or debris that may prevent a proper seal.
• Confirm breathing system components are fully seated.

Expected outcome: The absorber and breathing system seal properly.

Why it matters: A poorly seated absorber can create a significant circle system leak.

10. Perform a Leak Check or Checkout Test

• After correcting any external issue, perform the appropriate anesthesia machine checkout or leak test according to department procedure.
• Use a test lung or approved test setup if needed.
• Confirm the CIRCUIT LEAK alarm clears.
• Confirm the system passes leak check, ventilation pressure is maintained, delivered volume is reasonable for the setup, and no audible leaks remain.

Expected outcome: The Apollo passes leak testing and ventilates normally without the CIRCUIT LEAK alarm.

Why it matters: Passing a checkout confirms the leak was corrected before the anesthesia machine is returned to clinical use.

11. Isolate Accessory-Related vs Device-Related Leak

• If the alarm persists, replace or remove external items one at a time.
• Check the breathing circuit, breathing filter, breathing bag, CO2 sampling adapter, test lung, and any inline accessory.
• Repeat leak testing after each change.

Expected outcome: The leak is isolated to a replaceable external component or remains with the anesthesia machine.

Why it matters: This prevents unnecessary repair escalation for a simple disposable circuit, filter, or adapter issue.

12. Stop When Resolved

• If replacing or reconnecting the tube, hoses, filter, bag, absorber, or accessory corrects the CIRCUIT LEAK alarm, complete the checkout or leak test.
• Confirm normal ventilation.
• Return the anesthesia machine to service only after it passes testing.
• Document the corrected leak source in the work order.

If the Problem Persists

If the CIRCUIT LEAK alarm continues after the tube, hoses, filter, breathing bag, absorber canister, adapters, and external circuit components have been checked or replaced, external and common causes have been ruled out.

A persistent CIRCUIT LEAK alarm may indicate an internal breathing system seal issue, valve issue, internal pneumatic leak, sensor-related issue, or another device-level fault requiring bench evaluation.

• Remove the anesthesia machine from service.
• Label it Out of Service.
• Do not return it to patient use until the leak condition is resolved and the machine passes checkout.
• Send the unit for repair or qualified bench evaluation.

Knowing when to stop is proper troubleshooting.

Clinical Use Tip

Never troubleshoot on an active patient longer than necessary. If ventilation is affected or the leak source is not immediately obvious, move the patient to a backup device or alternate approved ventilation method first.

Work Order Documentation (CCR Method)

CCR = Complaint, Cause, Resolution

Complaint

What was reported by the clinical staff.

Example:
"Drager Apollo anesthesia machine reported CIRCUIT LEAK alarm. Staff reported leak in patient circle system during setup/use with concern for breathing circuit leak."

Cause

What was observed during troubleshooting.

Example:
"Leak traced to loose/damaged external circuit component, breathing hose, tube connection, filter, breathing bag, absorber seal, or adapter connection."

Resolution

What action was taken.

Example:
"Checked patient breathing circuit, tube connection, hoses, filter, adapters, breathing bag, and absorber canister. Corrected/replaced leaking component and performed leak check. Alarm cleared and unit passed checkout. Returned to service."

Helpful Details to Include (If Known)

• Alarm behavior
• Accessories swapped
• Power behavior
• Environmental factors
• Indicator lights
• Final device status

Final Thought

CIRCUIT LEAK alarms should be approached as patient safety issues first and equipment problems second. Start with the external breathing circuit, tube, hoses, filter, adapters, bag, and absorber before suspecting internal failure. If the leak cannot be corrected and verified by checkout, remove the anesthesia machine from service and document the findings clearly.

That is successful troubleshooting.