Laboratory Investigation of Six Artificial Noses for Use during Endotracheal Anesthesia

Weeks, Duke B.; Ramsey, F. M.

doi:10.1213/00000539-198308000-00010

Cited by 33 publications

(4 citation statements)

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“…The introduction of light, disposable devices that effectively conserve heat and moisture of inspired gases could be a solution to both the problem of humidification and that of heat preservation [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. HMEs preserve patients' heat and water, and overall recover 70% of expired heat and humidity [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Measurement of tracheal temperature is not a reliable index of total respiratory heat loss in mechanically ventilated patients

et al. 2000

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Background:Minimizing total respiratory heat loss is an important goal during mechanical ventilation. The aim of the present study was to evaluate whether changes in tracheal temperature (a clinical parameter that is easy to measure) are reliable indices of total respiratory heat loss in mechanically ventilated patients.Method:Total respiratory heat loss was measured, with three different methods of inspired gas conditioning, in 10 sedated patients. The study was randomized and of a crossover design. Each patient was ventilated for three consecutive 24-h periods with a heated humidifier (HH), a hydrophobic heat-moisture exchanger (HME) and a hygroscopic HME. Total respiratory heat loss and tracheal temperature were simultaneously obtained in each patient. Measurements were obtained during each 24-h study period after 45 min, and 6 and 24 h.Results:Total respiratory heat loss varied from 51 to 52 cal/min with the HH, from 100 to 108 cal/min with the hydrophobic HME, and from 92 to 102 cal/min with the hygroscopic HME (P < 0.01). Simultaneous measurements of maximal tracheal temperatures revealed no significant differences between the HH (35.7-35.9°C) and either HME (hydrophobic 35.3-35.4°C, hygroscopic 36.2-36.3°C).Conclusion:In intensive care unit (ICU) mechanically ventilated patients, total respiratory heat loss was twice as much with either hydrophobic or hydroscopic HME than with the HH. This suggests that a much greater amount of heat was extracted from the respiratory tract by the HMEs than by the HH. Tracheal temperature, although simple to measure in ICU patients, does not appear to be a reliable estimate of total respiratory heat loss.

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Section: Introductionmentioning

confidence: 99%

Measurement of tracheal temperature is not a reliable index of total respiratory heat loss in mechanically ventilated patients

et al. 2000

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“…Vaporizing humidifiers have some disadvantages: condensation of water that may be a source of infection, malfunctions, high maintenance cost and increased workload for nursing staff [8]. Heat and moisture exchangers (HMEs) with microbial filtration capacity (HME filters, HMEFs) might be a simple solution to the problems of conditioning respiratory gases and, possibly, of reducing the contamination of apparatus and subsequent bacterial pneumonia [9,10,11,12,13,14,15,16,17,18].…”

Section: Introductionmentioning

confidence: 99%

“…An important advance in the design of HMEs was made with the introduction of plastic foam impregnated with a hygroscopic substance as the active element [12,15,19]. The hygroscopic substance chemically absorbs a portion of the expired water vapor on the humidifier element that is collected by dry inspiratory gases.…”

Section: Introductionmentioning

confidence: 99%

Changing a hydrophobic heat and moisture exchanger after 48 hours rather than 24 hours: a clinical and microbiological evaluation

Boisson¹,

Viviand²,

Arnaud³

et al. 1999

Intensive Care Med

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Changing the hydrophobic HME after 48 h rather than 24 h did not affect its technical performance in terms of heat and water preservation of ventilatory gases. There is also some indirect evidence of very little, if any, change in HME resistance. No bacterial colonization of the ventilator sides of the HMEs was observed after 48 h of use. However, other large clinical trials should be undertaken to confirm the safety of extending the time between HME changes.

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“…Initial studies testing HMEs addressed their performance in the anesthesia settings, which entailed testing them for short periods of time. In a bench study, six different HMEs were found to provide an AH as low as 14 to 26 mg H2O/L [ 50 ]. As HMEs started to be tested in the intensive care unit setting, concerns regarding increased incidence of ETT occlusions aroused.…”

Section: Selecting the Appropriate Humidifiermentioning

confidence: 99%

Humidification during Mechanical Ventilation in the Adult Patient

Ashry

Modrykamien

2014

BioMed Research International

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Humidification of inhaled gases has been standard of care in mechanical ventilation for a long period of time. More than a century ago, a variety of reports described important airway damage by applying dry gases during artificial ventilation. Consequently, respiratory care providers have been utilizing external humidifiers to compensate for the lack of natural humidification mechanisms when the upper airway is bypassed. Particularly, active and passive humidification devices have rapidly evolved. Sophisticated systems composed of reservoirs, wires, heating devices, and other elements have become part of our usual armamentarium in the intensive care unit. Therefore, basic knowledge of the mechanisms of action of each of these devices, as well as their advantages and disadvantages, becomes a necessity for the respiratory care and intensive care practitioner. In this paper, we review current methods of airway humidification during invasive mechanical ventilation of adult patients. We describe a variety of devices and describe the eventual applications according to specific clinical conditions.

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Laboratory Investigation of Six Artificial Noses for Use during Endotracheal Anesthesia

Cited by 33 publications

References 0 publications

Measurement of tracheal temperature is not a reliable index of total respiratory heat loss in mechanically ventilated patients

Measurement of tracheal temperature is not a reliable index of total respiratory heat loss in mechanically ventilated patients

Changing a hydrophobic heat and moisture exchanger after 48 hours rather than 24 hours: a clinical and microbiological evaluation

Humidification during Mechanical Ventilation in the Adult Patient

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