Plotnikow Gustavo Adrián, Accoce Matias, Navarro Emiliano, Tiribelli Norberto
Capítulo de Kinesiología Intensivista, Sociedad Argentina de Terapia Intensiva, Buenos Aires, Argentina.
Rev Bras Ter Intensiva. 2018 Mar;30(1):86-97. doi: 10.5935/0103-507x.20180015.
Instrumentation of the airways in critical patients (endotracheal tube or tracheostomy cannula) prevents them from performing their function of humidify and heating the inhaled gas. In addition, the administration of cold and dry medical gases and the high flows that patients experience during invasive and non-invasive mechanical ventilation generate an even worse condition. For this reason, a device for gas conditioning is needed, even in short-term treatments, to avoid potential damage to the structure and function of the respiratory epithelium. In the field of intensive therapy, the use of heat and moisture exchangers is common for this purpose, as is the use of active humidification systems. Acquiring knowledge about technical specifications and the advantages and disadvantages of each device is needed for proper use since the conditioning of inspired gases is a key intervention in patients with artificial airway and has become routine care. Incorrect selection or inappropriate configuration of a device can have a negative impact on clinical outcomes. The members of the Capítulo de Kinesiología Intensivista of the Sociedad Argentina de Terapia Intensiva conducted a narrative review aiming to show the available evidence regarding conditioning of inhaled gas in patients with artificial airways, going into detail on concepts related to the working principles of each one.
危重症患者气道插管（气管内导管或气管切开套管）会妨碍其对吸入气体进行加湿和加热的功能。此外，在有创和无创机械通气过程中，患者吸入的冷干医用气体以及高流量气体，会使情况变得更糟。因此，即使是短期治疗，也需要一种气体调节装置，以避免对呼吸道上皮结构和功能造成潜在损害。在重症治疗领域，为此目的使用热湿交换器很常见，使用主动加湿系统也很常见。由于对吸入气体的调节是人工气道患者的关键干预措施且已成为常规护理，因此正确使用需要了解每种设备的技术规格以及优缺点。设备选择不当或配置不合适会对临床结果产生负面影响。阿根廷重症治疗学会重症运动学分会的成员进行了一项叙述性综述，旨在展示关于人工气道患者吸入气体调节的现有证据，并详细阐述与每种设备工作原理相关的概念。
