Da Fonseca J M, Wheeler D W, Pook J A
Department of Anaesthetics, University Hospital Lewisham, Lewisham High Street, London SE13 6LH, UK.
Anaesthesia. 2000 Jun;55(6):571-3. doi: 10.1046/j.1365-2044.2000.01521.x.
Heat and moisture exchangers (HMEs) humidify, warm and filter inspired gas, protecting patients and apparatus during anaesthesia. Their incorporation into paediatric anaesthetic breathing systems is recommended. We experienced delays in inhalational induction whilst using a Mapleson F breathing system with an HME. We have demonstrated that the HME significantly alters gas flow within the breathing system. Approximately half of the fresh gas flow is delivered to the patient, the remainder being wasted into the expiratory limb of the breathing system. We suggest that the HME should be removed from the Mapleson F breathing system until inhalational induction is complete, or that the reservoir bag is completely occluded until an effective seal is obtained with the mask.
热湿交换器（HMEs）可对吸入气体进行加湿、加热和过滤，在麻醉期间保护患者和设备。建议将其纳入小儿麻醉呼吸系统。我们在使用带有HME的Mapleson F呼吸系统进行吸入诱导时遇到了延迟。我们已经证明，HME会显著改变呼吸系统内的气流。大约一半的新鲜气流输送给患者，其余则浪费在呼吸系统的呼气支中。我们建议在吸入诱导完成之前，应将HME从Mapleson F呼吸系统中移除，或者在通过面罩获得有效密封之前，将贮气囊完全堵塞。
