High Peak Inspiratory Pressures After a Change of Heat and Moisture Exchangers: A Case Series

Dewasurendra, Anusari M.; McHugh, Stephen M.

doi:10.1213/xaa.0000000000001483

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…However, their use can also lead to complications such as HME occlusion, disconnections, unnoticed leaks, and risk of infections, which can result in an acute increase in airway pressure and difficulties with ventilation. HME occlusion can occur due to a variety of factors, including excessive moisture accumulation from the patient's exhalation or the breathing system, kinking of the HME tubing, or blockage of the HME filter [ 3 , 6 ]. In our case, the accumulated moisture was likely the result of a buildup of condensed exhaled gases, which had clogged the HME’s electrostatic membrane filter.…”

Section: Discussionmentioning

confidence: 99%

Heat and Moisture Exchanger Occlusion Leading to Sudden Increased Airway Pressure: A Case Report Using ChatGPT as a Personal Writing Assistant

Hallo-Carrasco¹,

Gruenbaum²,

Gruenbaum³

2023

Cureus

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Heat and moisture exchangers (HMEs) are commonly used during general anesthesia to provide appropriate humidification and warming of inspired gases. While they play a critical role in mechanical ventilation, they can also lead to acute difficult ventilation if not correctly monitored and drained. We present a case of a 56year-old female patient who underwent lower extremity vascular bypass surgery under general anesthesia and experienced sudden increased airway pressures due to occlusion of the HME caused by excessive moisture accumulation. Proper monitoring and management of the airway circuit and HMEs can help prevent complications and ensure proper ventilation during surgery. When acute difficult ventilation is encountered during general anesthesia, a systematic approach should be taken to differentiate between patient and external factors. Other differential diagnoses for acute difficult ventilation include bronchospasm, aspiration, endotracheal tube misplacement, pulmonary embolism, and tension pneumothorax. HME occlusion should be considered as part of the differential diagnosis for intraoperative hypoxia. Proactive replacement of HMEs in long cases can prevent occlusion and ensure proper ventilation.

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Section: Discussionmentioning

confidence: 99%

Heat and Moisture Exchanger Occlusion Leading to Sudden Increased Airway Pressure: A Case Report Using ChatGPT as a Personal Writing Assistant

Hallo-Carrasco¹,

Gruenbaum²,

Gruenbaum³

2023

Cureus

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Pressure-controlled ventilation-volume guaranteed mode improves bronchial mucus transport velocity in patients during laparoscopic surgery for gynecological oncology: a randomized controlled study

Deng,

Xu,

Wang

et al. 2023

BMC Anesthesiol

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Background Mechanical ventilation during general anesthesia may impair airway mucosal function. This study aimed to investigate the effect of pressure-controlled ventilation-volume guaranteed (PCV-VG) on bronchial mucus transport velocity (BTV) in patients during laparoscopic surgery for gynecological oncology compared with volume controlled ventilation (VCV). Methods 66 patients undergoing elective a laparoscopic surgery for gynecological oncology. The patients were randomized into two group receiving either PCV-VG or VCV. a drop of methylene blue was placed on the surface of the airway mucosa under the bronchoscopeand, then the distance the dye movement was measured after 2, 4, and 6 min. Outcomes were assessed at T0 (5 min after endotracheal intubation and before initiation of pneumoperitoneum), T1 and T2 (1 and 2 h after stabilization of pneumoperitoneum respectively). BTV at T0, T1 and T2 was the primary outcome. Secondary outcomes included heart rate (HR), mean arterial pressure (MAP), body temperature, end-tidal CO2 pressure (PETCO2), tidal volume(VT), peak inspiratory pressure (PIP), mean inspiratory pressure (Pmean), respiratory rate (RR), and dynamic compliance (CDyn) at T0, T1, and T2. Results 64 patients were included in the analysis. The median [interquartile range] BTV was significantly lower in VCV group at T1 and T2 that at T0 (P < 0.05). Furthermore, BTV was slightly reduced in PCV-VG compared with VCV. BTV in PCV-VG was significantly decreased at T2 compared with BTV at T0 (P < 0.05) and slightly decreased at T1 compared with T0(P > 0.05). Compared with the PCV-VG group, BTV in VCV group significantly decreased at T2 (P < 0.05). No participants experienced respiratory complications. Conclusions PCV-VG is more suitable for patients undergoing laparoscopic surgery for gynecological oncology than VCV since it can protect mucociliary clearance function. Trial registration This trial is registered on https://www.chictr.org.cn/ in Chinese Clinical Trial Registry (ChiCTR.2200064564: Date of registration 11/10/2022).

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Heat and moisture exchangers in intensive care: benefits and risks of their use in mechanically ventilated critically ill patients

Línková,

Rambousková,

Jiroutková

et al. 2024

Anest. intenziv. Med.

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High Peak Inspiratory Pressures After a Change of Heat and Moisture Exchangers: A Case Series

Cited by 3 publications

References 10 publications

Heat and Moisture Exchanger Occlusion Leading to Sudden Increased Airway Pressure: A Case Report Using ChatGPT as a Personal Writing Assistant

Heat and Moisture Exchanger Occlusion Leading to Sudden Increased Airway Pressure: A Case Report Using ChatGPT as a Personal Writing Assistant

Pressure-controlled ventilation-volume guaranteed mode improves bronchial mucus transport velocity in patients during laparoscopic surgery for gynecological oncology: a randomized controlled study

Heat and moisture exchangers in intensive care: benefits and risks of their use in mechanically ventilated critically ill patients

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