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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
NURSING SMART 2003 - Milan, may 28-30
Minerva Anestesiologica 2003 April;69(4):297-301
A rationale basis for airways conditioning: too wet or not too wet?
Severgnini P. 1, D’Onofrio D. 1, Frigerio A. 1, Apostolou G. 1, Chiumello D. 2, LiBassi G. 2, Storelli E. 2, Pelosi P. 1, Chiaranda M. 1
1 Dipartimento di Scienze Cliniche e Biologiche, Università degli Studi dell’Insubria, Varese, Italia
2 Istituto di Anestesia e Rianimazione, Università degli Studi di Milano, Ospedale Maggiore Policlinico-IRCCS, Milano, Italia
Medical gases conditioning during mechanical invasive ventilation is nowadays a problem.
In fact, in spite of conditioning guidelines, absolute humidity (AH) into 25-35 mg/l, clinical evaluation of the optimal level of airway humidification has not yot been established with certainty.
Physiologically, during spontaneous respiration the airway hydric balance, inspiratory AH – expiratory AH, is negative of 27 mg/l about.
Usually the patients on mechanical ventilation have an expiratory AH of 32-33 mg/l. An overhumidification of inspired gases, positive airway hydric balance, gives anatomic-physiological alterations of airways and lung parenchyma.
During invasive mechanical ventilation, the practice of active hot humidifiers has a positive or level airway hydric balance.
We think that inspired AH must be equal to expired AH to maintain an airway hydric balance at least level. At last, the temperature of inspired gases, with active hot humidifiers, shouldn’t exceed 32-34 °C.