Przedłużone stosowanie wymienników ciepła i wilgoci – ocena wydajności

Artur Florek, Andrzej Nestorowicz, Edyta Kotlińska-Hasiec

Summary
Background. Heat and moisture exchangers (HME) are a convenient alternative to the heated water humidifiers, commonly used in intensive therapy settings. According to the manufacturer, they should be exchanged every 24 hours. We have assessed the efficacy of the Hygrobac (Mallinckrodt, Italy) HMEs during use extended to 72 hours. Methods. Twenty adult patients with acute respiratory failure were enrolled in the study. All were ventilated by CMV or SIMV mode for at least 72 hours, with constant settings. HME efficiency was evaluated by psychrometry, using three temperature probes installed within the breathing systems. Every 24 hours, we measured the temperatures of the inspiratory gases, absolute and relative humidity, peak and mean airway pressures, arterial blood gases, and ambient temperature. Results. Inspiratory gas temperatures were 30.25 ±0.83°C, 30.58 ±0.94°C, 30.38 ±0.92°C), the absolute humidity was 29.84 ±1.31, 30.15 ±1.47 and 29.97 ±1.52 mg H₂O l^-1), the relative humidity – 96.38 ±1.61%, 96.15 ±1.75% and 96.30 ±1.50%. Obtained results were not statistically significant. Discussion and conclusion. HMEs provided a convenient and cheap alternative to cascade humidifiers during prolonged artificial ventilation. In addition, contamination of the respiratory gases was prevented. We proved that appropriate humidity and temperature of respiratory gases can be maintained for 72 hours with a single HME, without disturbances in gas exchange.

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