Instrumentation of the airways in critical patients (endotracheal tube or
tracheostomy cannula) prevents them from performing their function of humidify
and heating the inhaled gas. In addition, the administration of cold and dry
medical gases and the high flows that patients experience during invasive and
non-invasive mechanical ventilation generate an even worse condition. For this
reason, a device for gas conditioning is needed, even in short-term treatments,
to avoid potential damage to the structure and function of the respiratory
epithelium. In the field of intensive therapy, the use of heat and moisture
exchangers is common for this purpose, as is the use of active humidification
systems. Acquiring knowledge about technical specifications and the advantages
and disadvantages of each device is needed for proper use since the conditioning
of inspired gases is a key intervention in patients with artificial airway and
has become routine care. Incorrect selection or inappropriate configuration of a
device can have a negative impact on clinical outcomes. The members of the
Capítulo de Kinesiología Intensivista of the
Sociedad Argentina de Terapia Intensiva conducted a
narrative review aiming to show the available evidence regarding conditioning of
inhaled gas in patients with artificial airways, going into detail on concepts
related to the working principles of each one.
In healthy subjects, the semi-seated position and the use of HFNC increased end-expiratory lung impedance globally. These changes were accompanied by a significant decrease in the breathing frequency.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.