Abstract
The main purposes of the upper airways are warming, humidifying and filtering the inspired air. The mechanisms of filtration and heat and moisture exchange between mucosa and ventilated air are sufficient even under extreme atmospheric conditions. However, artificial conditioning of the inspired air is necessary in intubated patients due to the elimination of the functions of the upper airways by the endotracheal tube. The isothermic saturation border moves from the lower part of the trachea to areas distal to the pulmonary bifurcation. Warming, humidification, and filtration of the inspired air is shifted towards areas of the bronchial system which are not appropriate for these functions. Morphological damage to the sensitive respiratory epithelium are inevitable if no effective conditioning of the inspired air is provided. Therefore, measures to maintain or restore the physiological condition of air in the airways are necessary immediately subsequent to intubation.
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References
Ingelstedt S (1956) Studies of the conditioning of air in the respiratory tract. Acta otolaryngologica 131: 1–81
Déry R (1973) The evolution of heat and moisture in the respiratory tract during anaesthesia with a non-rebreathing system. Can Anaesth Soc J 20: 296–306
Déry R, Pelletier J, Jaques A, Clavet M, Houde JJ (1967) Humidity in anaesthesiology. III. Heat and moisture patterns in the respiratory tract during anaesthesia with the semi-closed system. Can Anaesth Soc J 14: 287–298
Forbes AR (1974) Temperature, humidity and mucus flow in the intubated trachea. Br J Anaesth 46: 29–34
McFadden ER (1983) Respiratory heat and water exchange: Physiological and clinical implications. J Appl Physiol 54: 331–336
Walker JEC, Wells ER, Merrill EW (1961) Heat and water exchange in the respiratory tract. Am J Med 30: 259–267
Weast RC (1975) Handbook of chemistry and physics. 56th edition, CRC press, Cranwood Parkway, Cleveland Ohio
Cohen JL, Weinberg PF, Fein JA, Rowinski GS (1988) Endotracheal tube occlusion associated with the use of heat and moisture exchangers in the intensive care unit. Crit Care Med 16: 277–279
Chalon J, Loew DAY, Malebranch J (1972) Effects of dry anaesthetic gases on tracheobronchial ciliated epithelium. Anaesthesiology 37: 338–343
Kleemann PP (1990) The climatisation of anesthetic gases under conditions of high flow to low flow. Acta Anaesthesiol Belg 41: 189–200
International Standard Organisation ISO 8185 (1988) Humidifiers for medical use - safety requirements
Shelly MP, Lloyd GM, Park GR (1988) A review of the mechanisms and methods of humidification of inspired gases. Intensive Care Med 14: 1–9
Rathgeber J, Züchner K, Kietzmann, Weyland W (1995) Heat and moisture exchangers for humidifying the inspired air of intubated patients in intensive care medicine. An investigation of humidification properties of heat and moisture exchangers under clinical conditions. Anaesthesist 44: 274–283
Rathgeber J, Züchner K, Weyland W, Bettka T (1996) Heated humidifiers and heat and moisture exchanger in the treatment of perioperative heat loss and in rewarming of hypothermic patients. Anaesthesist 45 (In press)
Rathgeber J, Henze D, Züchner K, Kettler D (1996) Conditioning of the inspired air with HME (Heat and Moisture Exchangers) - an effective and cost saving alternative to heated humidifiers in long-term ventilated patients. A prospective randomized clinical study. Anaesthesist 45 (In press)
Klein EF, Graves SA (1974) “Hot pot” tracheitis. Chest 65: 225–226
Rathgeber J, Zielmann S, Kietzmann D, Züchner K, Warnecke G (1992) Is the use of lithium-chlorid-coated HME (heat and moisture exchanger) dangerous for patients? Anaesthesist 41 : 204–207
Primiano FP, Moranz ME, Montague FW, Miller RB, Sachs DLP (1984) Conditioning of inspired air by a hygroscopic condenser humidifier. Crit Care Med 12: 675–678
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© 1996 Springer-Verlag Berlin Heidelberg
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Rathgeber, J., Züchner, K., Burchardi, H. (1996). Conditioning of Air in Mechanically Ventilated Patients. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 1996. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80053-5_41
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DOI: https://doi.org/10.1007/978-3-642-80053-5_41
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