An Evaluation of Six Disposable Heat and Moisture Exchangers

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Abstract
Six disposable heat and moisture exchangers were tested on patients undergoing anaesthesia requiring mechanical ventilation. Inspiratory humidity and temperature were monitored to find the steady-state values reached with each device together with the times taken for these to be achieved. The exchangers were tested in a non-rebreathing T-piece circuit and in a conventional circle system with a fresh gas flow of 6 l/min: the Siemens 150 provided 28 and 32 mg of water/litre of inspired gas (at about 30°C) in 10 and 5 min respectively, but is rather heavy and bulky. The Portex Humidvent provided 25 and 30 mg/l, and although taking longer to reach steady state (27 and 15 min respectively) is small, light and cheap. The Siemens 151 provided 25 and 27 mg/l in 18 and 10 min respectively, but is heavier than the Portex exchanger. The performances of these three devices were not significantly different from each other in either study (P < 0.05). For the T-piece system the Pall and Engstrom exchangers were the next most efficient. The Pall device provided 18 and 23 mg/l (in 18 and 8 min respectively) and the Engstrom provided 20 and 23 mg/l (in 19 and 10 min respectively). In the circle system, there were no significant differences between the peformances of the Portex, Siemens 151, Pall and Engstrom exchangers. The Pall is also a very effective bacterial filter and has been found to be satisfactory in the intensive care setting. The Terumo appeared to perform no better than a circle system with catheter mount (13 mg/l at 27°C). It would seem that more complex humidification equipment is not necessary during anaesthesia if an efficient heat and moisture exchanger is used.