The effect of a heat and moisture exchanger (HME) on bronchial mucus transport in a closed inhalation anesthesia system

Der Anaesthesist
F KonradM Georgieff

Abstract

The administration of dry anaesthetic gases for ventilation leads to morphological changes of the tracheobronchial epithelium that may cause postoperative pulmonary complications. Therefore, additional humidification with a heat and moisture exchanger (HME) is suggested for ventilation during anaesthesia, particularly when using semi-open breathing systems. Recommendations concerning the use of a HME in the semi-closed system are controversial. There are no data in the literature as to whether a HME improves mucociliary transport under these conditions. We therefore studied bronchial mucus transport velocity (BTV) with and without the use of a HME in the semi-closed circle system in humans. The study was approved by the ethics committee of our hospital. In a prospective, randomised trial a total of 22 patients undergoing major abdominal surgery were investigated. In all patients anaesthesia was induced and maintained with midazolam, fentanyl, and vecuronium. After intubation, a HME (BACT/VIRAL HME, Pharma Systems AB, Sweden) was inserted between the endotracheal tube and ventilation tubing in 11 patients; the other 11 were ventilated without a HME and served as controls. Ventilation was assisted with a fresh flow of 3 in a semi...Continue Reading

Citations

Oct 23, 2014·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·C van den BoerS van der Baan
Apr 11, 2008·The Journal of Trauma·Ronald PauldineDavid W Kaczka

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