The temperature and humidity of inspired gases in infants using a pediatric circle system: effects of high and low‐flow anesthesia

Hunter, Ted; Lerman, Jerrold; Bissonnette, Bruno

doi:10.1111/j.1460-9592.2005.01559.x

Cited by 11 publications

(7 citation statements)

References 10 publications

(25 reference statements)

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“…In both levels of set temperatures in our study, the targeted inspired gas temperature did not reach the patient. The temperature of the gas reaching the patient was found to be around incubator temperature settings or room temperature in other reports studying term newborn infants 6,23,24. In studies that used a model lung attached to the ventilator circuit, the results were found to be approximately the same.…”

Section: Discussionmentioning

confidence: 71%

“…1,2,5,6,20,22 It is therefore suggested that humidifier temperatures should be adjusted to 39°C to 40°C so that the target temperature for infants can be reached. 1,[5][6][7]10,11,22,23 As far as we know, our study is the first to measure inspired air temperature and humidity for preterm neonates. Our results were similar to those of Fassassi et al, 24 Hunter et al, 23 and Davies et al, 6 showing that there was a drop in the temperature of the inspired gas reaching the patient.…”

Section: Discussionmentioning

confidence: 99%

“…However, recent studies have shown that the set temperature in humidifiers does not reach the airway of the preterm infant 1,2,5,6,20,22. It is therefore suggested that humidifier temperatures should be adjusted to 39°C to 40°C so that the target temperature for infants can be reached 1,5–7,10,11,22,23…”

Section: Discussionmentioning

confidence: 99%

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The Effect of 2 Humidifier Temperature Settings on Inspired Gas Temperatures and the Physiological Parameters of Preterm Infants Receiving Mechanical Ventilation Therapy

Bayraktar¹,

Balcı

İnce

2020

Advances in Neonatal Care

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Background: The use of heated and humidified gas during mechanical ventilation is routine care in neonatal intensive care units. Giving gas at inadequate heat and humidity levels can affect neonatal morbidity and mortality. Purpose: To compare the effects of 2 humidifier temperature settings on the temperature and humidity of the inspired gas and the physiologic parameters in preterm newborns receiving mechanical ventilation. Methods: The research was conducted in a single-group quasi-experimental design. Proximal temperature was measured using a humidity heat transmitter. The humidifier temperature was set at 38°C (temperature I) and then at 39°C (temperature II). Results: The mean proximal temperatures were significantly lower than the values set in the humidifier (33.8 ± 1.20°C at temperature I, and 34.06 ± 1.30°C at temperature II, P < .001). However, the difference between the 2 proximal temperatures was not significant (P = .162). The incubator temperature was found to be effective on the proximal gas temperature (P < .05). It was found that only preterm infants in the temperature II group had a higher mean heart rate (P < .05). Implications for Practice: Incubator temperatures may have an effect on inspired gas temperature in preterm infants who are mechanically ventilated and caregivers should be aware of these potentially negative effects. Implications for Research: Future studies should focus on how to measure the temperature and humidity of gas reaching infants in order to prevent heat and humidity losses.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

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The Effect of 2 Humidifier Temperature Settings on Inspired Gas Temperatures and the Physiological Parameters of Preterm Infants Receiving Mechanical Ventilation Therapy

Bayraktar¹,

Balcı

İnce

2020

Advances in Neonatal Care

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“…However, our data showed similar mean temperatures of the inhaled gases in the control and TI groups; additionally, the differences between the mean temperatures of the gases of the workstation inspiratory limb and the inhaled gases were small (approximately 1°C) and did not differ between the control and TI groups and between the HME and TIHME groups. The speed and amount of heat loss are directly related to the heat transfer coefficient of the material and the length of the inspiratory limb of the breathing circuit [ 25 ]. In some studies performed with a low FGF and silicone corrugated tubes in the breathing circuit, the inhaled gas temperature was lower (approximately 4°C) than the workstation inspiratory limb gas temperature [ 14 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

The Humidity in a Low-Flow Dräger Fabius Anesthesia Workstation with or without Thermal Insulation or a Heat and Moisture Exchanger: A Prospective Randomized Clinical Trial

et al. 2017

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BackgroundDuring anesthesia, as compared with intensive care, the time of the tracheal intubation is much shorter. An inhaled gas minimum humidity of 20 mgH2O.L-1 is recommended to reduce the deleterious effects of dry gas on the airways during anesthesia with tracheal intubation. The Fabius GS Premium® anesthesia workstation (Dräger Medical, Lübeck, Germany) has a built-in hotplate to heat gases in the breathing circuit. A heat and moisture exchanger (HME) is used to further heat and humidify the inhaled gas. The humidity of the gases in the breathing circuit is influenced by the ambient temperature. We compared the humidity of the inhaled gases from a low-flow Fabius anesthesia workstation with or without thermal insulation (TI) of the breathing circuit and with or without an HME.MethodsWe conducted a prospective randomized trial in 41 adult female patients who underwent elective abdominal surgery. The patients were allocated into four groups according to the devices used to ventilate their lungs using a Dräger Fabius anesthesia workstation with a low gas flow (1 L.min-1): control, with TI, with an HME or with TI and an HME (TIHME). The mean temperature and humidity of the inhaled gases were measured during 2-h after connecting the patients to the breathing circuit.ResultsThe mean inhaled gas temperature and absolute humidity were higher in the HME (29.2±1.3°C; 28.1±2.3 mgH2O·L-1) and TIHME (30.1±1.2°C; 29.4±2.0 mgH2O·L-1) groups compared with the control (27.5±1.0°C; 25.0±1.8 mgH2O·L-1) and TI (27.2±1.1°C; 24.9±1.8 mgH2O·L-1) groups (P = 0.003 and P<0.001, respectively).ConclusionsThe low-flow Fabius GS Premium breathing circuit provides the minimum humidity level of inhaled gases to avoid damage to the tracheobronchial epithelia during anesthesia. TI of the breathing circuit does not increase the humidity of the inhaled gases, whereas inserting an HME increases the moisture of the inhaled gases closer to physiological values.

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“…S ir —I read with interest the article by Hunter et al (1) addressing the effect of low‐flow anesthesia on temperature and humidity in a circle system. The experimental setup with 16 sites for recording the mean airway temperatures was fruitful, and the discussion illuminated the factors influencing heat loss in a pediatric breathing circuit.…”

mentioning

confidence: 99%

Low flow and temperature

Frykholm

2006

Pediatric Anesthesia

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The temperature and humidity of inspired gases in infants using a pediatric circle system: effects of high and low‐flow anesthesia

Cited by 11 publications

References 10 publications

The Effect of 2 Humidifier Temperature Settings on Inspired Gas Temperatures and the Physiological Parameters of Preterm Infants Receiving Mechanical Ventilation Therapy

The Effect of 2 Humidifier Temperature Settings on Inspired Gas Temperatures and the Physiological Parameters of Preterm Infants Receiving Mechanical Ventilation Therapy

The Humidity in a Low-Flow Dräger Fabius Anesthesia Workstation with or without Thermal Insulation or a Heat and Moisture Exchanger: A Prospective Randomized Clinical Trial

Low flow and temperature

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