Doyle Alexander, Mariyaselvam Maryanne, Wijewardena Gayathri, English Natalie, Gent Emma, Young Peter
Department of Anaesthesia and Critical Care, Queen Elizabeth Hospital, Gayton Road, Kings Lynn, Norfolk, UK, PE30 4ET; Specialty trainee, Barts and the London School of Anaesthesia, The Royal London Hospital, Whitechapel, London, UK, E1 1BB.
Department of Anaesthesia and Critical Care, Queen Elizabeth Hospital, Gayton Road, Kings Lynn, Norfolk, UK, PE30 4ET.
J Crit Care. 2015 Aug;30(4):863.e1-3. doi: 10.1016/j.jcrc.2015.03.033. Epub 2015 Apr 8.
Heat and moisture exchangers (HMEs) and heated humidifiers (HHs) may be used together inadvertently. Such an incident occurred at our institution resulting in airway occlusion.
A bench-top study was conducted to compare the incidence of airway occlusion when using (1) no airway humidification, (2) HME alone, (3) HH alone, and (4) both HME and HH in combination as part of a standard breathing circuit.
The simultaneous use of a HME and a HH was associated with a reduction in tidal volume (no airway humidification, P ≤ .05; HME alone, P ≤ .01; and HH alone, P ≤ .01) and an increased incidence of airway occlusion (no airway humidification, 0/7; HME alone, 0/7; HH alone, 0/7; and HME and HH in combination, 7/7; P < .0001).
The use of a HME and a HH in combination is likely to result in airway occlusion. Precautions should be taken to ensure that both systems are not used together in clinical practice.
热湿交换器（HME）和加热湿化器（HH）可能会被意外同时使用。我们机构就发生了这样一起导致气道阻塞的事件。
进行了一项台式研究，以比较在作为标准呼吸回路一部分使用时，（1）不进行气道湿化、（2）仅使用HME、（3）仅使用HH以及（4）同时使用HME和HH这四种情况下气道阻塞的发生率。
同时使用HME和HH与潮气量减少相关（不进行气道湿化，P≤0.05；仅使用HME，P≤0.01；仅使用HH，P≤0.01），且气道阻塞发生率增加（不进行气道湿化，0/7；仅使用HME，0/7；仅使用HH，0/7；同时使用HME和HH，7/7；P<0.0001）。
同时使用HME和HH可能会导致气道阻塞。临床实践中应采取预防措施，确保这两种系统不同时使用。
