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[呼吸回路中吸入气体是否需要湿度过滤器?一种测量呼出气体中湿度的新体内方法]

[Are humidity filters necessary in the inspired air in the breathing circuit? A new in vivo method of measuring humidity in the air breathed].

作者信息

Kohler P, Rimek A, Albrecht M, Frankenberger H, Mertins W, van Ackern K

机构信息

Institut für Anästhesiologie und Operative Intensivmedizin des Klinikums der Stadt Mannheim.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 1992 May;27(3):149-55. doi: 10.1055/s-2007-1000270.

Abstract

Humidification of inspiratory gases under anaesthetic conditions still is a matter of controversial discussion. Physiological humidification and heating of breathing air are preconditions for mucociliary clearance, pulmonary cleaning and defence mechanisms. These functions of the upper respiratory tract are eliminated by application of artificial airways. In general the humidification of inspiratory gases should not remain under 70% of relative air humidity at 37 degrees C. Under clinical conditions it is problematic to ensure sufficiently rapid and reproducible measurements of humidity during breathing cycles. We developed a measuring method that enables to make these measurements without big mechanical device. Aim of this investigation was to measure air humidity in typical semiclosed systems during anaesthesia and semiopen CPAP-respiration. The necessity and efficiency of a heat and moisture exchanger (HME) was to be investigated as well. After approximately 5 minutes there was an inspiratory relative air humidity not below 70% at 28 degrees C (19 mg H2O/l humid air) within the breathing circuit with CO2 double-absorber. By using an HME it is possible to increase relative air humidity within this system to 86% at 29.5 degrees C (25 mg/l). After one hour's respiration with this system without HME a relative humidity of 87% at 30 degrees C (26 mg/l) is reached after replaced HME. Initial relative humidity in a semiopen CPAP-system is about 12% at 28 degrees C (3 mg/l). This is increased to 85% at 29.5 degrees C (25 mg/l) after 15 minutes respiration with HME.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在麻醉条件下对吸入气体进行湿化仍是一个存在争议的讨论话题。呼吸空气的生理湿化和加热是黏液纤毛清除、肺部清洁及防御机制的前提条件。上呼吸道的这些功能会因使用人工气道而丧失。一般来说,吸入气体的湿化在37℃时相对空气湿度不应低于70%。在临床条件下,要在呼吸周期中确保足够快速且可重复的湿度测量存在问题。我们开发了一种测量方法,无需大型机械设备就能进行这些测量。本研究的目的是测量麻醉期间典型半封闭系统以及半开放式持续气道正压通气(CPAP)呼吸时的空气湿度。同时还要研究热湿交换器(HME)的必要性和效率。在带有二氧化碳双吸收器的呼吸回路中,大约5分钟后,28℃时的吸气相对空气湿度不低于70%(19毫克水/升湿空气)。使用HME可使该系统内的相对空气湿度在29.5℃时提高到86%(25毫克/升)。在该系统不使用HME呼吸1小时后,更换HME后,30℃时的相对湿度达到87%(26毫克/升)。半开放式CPAP系统的初始相对湿度在28℃时约为12%(3毫克/升)。使用HME呼吸15分钟后,在29.5℃时可提高到85%(25毫克/升)。(摘要截选至250字)

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