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Use of heat and moisture exchanging (HME) filters in mechanically ventilated ICU patients: Influence on airway flow-resistance

Abstract

Objective

To investigate the flow-resistance of a new generation of Heat Moisture Exchanging Filters (HME filters) during 24 h of clinical use.

Design

Before-after trial.

Setting

A general Intensive Care Unit of a university hospital.

Patients

A consecutive series of 96 patients undergoing mechanical ventilation for respiratory insufficiency of various etiology and severity.

Methods

The characteristics of the secretions collected by tracheal suctioning and the pressure/flow relationship of the HMEs before and after 24h of clinical use were analyzed.

Results

The resistance of the HMEs when dry was 2hPa/l·s, and its increased to a maximum of 1 hPa/l·s in 83% of the patients after 24 hours; in four patients with particularly heavy secretions HME resistance was 4-5hPa/l·s. There were no significant modifications of the secretions within the investigation period, excluding, in particular, an increase in density with consequent tracheal tube obstruction.

Conclusion

The gas conditioning efficiency and design performance of the tested HMEs did not create a significant obstacle to airflow medium term mechanical ventilation; however, these devices should be cautiously used in patients with heavy bronchial secretions.

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Chiaranda, M., Verona, L., Pinamonti, O. et al. Use of heat and moisture exchanging (HME) filters in mechanically ventilated ICU patients: Influence on airway flow-resistance. Intensive Care Med 19, 462–466 (1993). https://doi.org/10.1007/BF01711088

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  • DOI: https://doi.org/10.1007/BF01711088

Key words

  • Heat
  • Humidity
  • Respiration
  • Artificial Instrumentation
  • HME