Breathing system filters for paediatric practice

Bennett, N. R.; Bingham, Robert

doi:10.1111/j.1365-2044.2007.04958_1.x

Cited by 1 publication

(1 citation statement)

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“…In order to allow for easier comparison of the resistances of the investigated airway components we arbitrarily chose an exemplary flow rate of 300 mL s −1 . This flow rate may appear disproportionally high for small infants . However, we consider this flow rate representative for a wide range of spontaneously breathing pediatric patients.…”

Section: Limitationsmentioning

confidence: 99%

Pressure‐flow characteristics of breathing systems and their components for pediatric and adult patients

Wenzel

Schumann

Spaeth

2017

Pediatric Anesthesia

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Summary Background Breathing circuits connect the ventilator to the patients’ respiratory system. Breathing tubes, connectors, and sensors contribute to artificial airway resistance to a varying extent. We hypothesized that the flow‐dependent resistance is higher in pediatric breathing systems and their components compared to respective types for adults. Aims We aimed to characterize the resistance of representative breathing systems and their components used in pediatric patients (including devices for adults) by their nonlinear pressure‐flow relationship. Methods We used a physical model to measure the flow‐dependent pressure gradient (∆P) across breathing tubes, breathing tube extensions, 90°‐ and Y‐connectors, flow‐ and carbon dioxide sensors, water traps and reusable, disposable and coaxial breathing systems for pediatric and for adult patients. ∆P was analyzed for usual flow ranges and statistically compared at a representative flow rate of 300 mL∙s−1 (∆P300). Results ∆P across pediatric devices always exceeded ∆P across the corresponding devices for adult patients (all P < .001 [no 95% CI includes 0]). ∆P300 across breathing system components for adults was always below 0.2 cmH2O but reached up to 4.6 cmH2O in a flow sensor for pediatric patients. ∆P300 was considerably higher across the reusable compared to the disposable pediatric breathing systems (1.9 vs 0.3 cmH2O, P < .001, [95% CI −1.59 to −1.56]). Conclusion The resistances of pediatric breathing systems and their components result in pressure gradients exceeding those for adults several fold. Considering the resistance of individual components is crucial for composing a breathing system matching the patient's needs. Compensation of the additional resistance should be considered if a large composed resistance is unavoidable.

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Section: Limitationsmentioning

confidence: 99%