Bissonnette B, Sessler D I, LaFlamme P
Department of Anesthesia, Hospital for Sick Children, Toronto, Ontario, Canada.
Anesthesiology. 1989 Sep;71(3):350-4. doi: 10.1097/00000542-198909000-00006.
The hypothesis that both active and passive airway humidification prevents hypothermia in infants and children, but that neither decreases the duration of postoperative recovery was tested. Twenty-seven ASA physical status 1 or 2 patients were studied who weighed between 5 and 30 kg, underwent superficial operations, were anesthetized with halothane and 70% N2O, and whose lungs were ventilated via a Rees modification of an Ayre's t-piece. The children were randomly assigned to receive active airway humidification and warming using an MR450 Servo airway heater and humidifier set at 37 degrees C (n = 10), passive airway humidification using the Humid-Vent 1 heat and moisture exchanger placed between the Ayre's t-piece and the endotracheal tube (n = 8), or no airway humidification and heating (control, n = 9). Distal tracheal and tympanic membrane temperatures and airway humidity were recorded during the first 90 min of surgery. Rectal temperature was measured during the postanesthetic recovery period. Relative humidity of inspired respiratory gases was approximately 30% in the control group and approximately 90% in the group given active airway humidification. Initial inspired humidity in the passive humidification group (50%) increased to approximately 80%, a level not significantly different from that in the active group after 80 min of anesthesia. Central body temperature increased 0.25 degrees C during active active airway humidification and heating, whereas temperature decreased 0.25 degrees C during passive humidification and 0.75 degrees C without airway humidification. Distal tracheal temperature was significantly higher in the groups given passive and active humidification than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)
主动和被动气道湿化均可防止婴幼儿体温过低,但两者均不会缩短术后恢复时间。研究了27例ASA身体状况为1或2级、体重在5至30公斤之间、接受浅表手术、使用氟烷和70%氧化亚氮麻醉且通过对Ayre氏T形管进行Rees改良来进行肺通气的患者。这些儿童被随机分配,分别接受使用设置为37摄氏度的MR450伺服气道加热器和加湿器进行主动气道湿化和加温(n = 10)、使用置于Ayre氏T形管和气管内导管之间的Humid-Vent 1热湿交换器进行被动气道湿化(n = 8),或不进行气道湿化和加温(对照组,n = 9)。在手术的前90分钟记录气管远端和鼓膜温度以及气道湿度。在麻醉后恢复期间测量直肠温度。对照组吸入呼吸气体的相对湿度约为30%,主动气道湿化组约为90%。被动湿化组的初始吸入湿度(50%)在麻醉80分钟后升至约80%,这一水平与主动组无显著差异。主动气道湿化和加温期间中心体温升高0.25摄氏度,而被动湿化期间体温下降0.25摄氏度,无气道湿化时体温下降0.75摄氏度。被动和主动湿化组的气管远端温度显著高于对照组。(摘要截断于250字)