Airway obstruction in heat & moisture exchanger filter -A case report-

다국어 초록 (Multilingual Abstract)

Heat and moisture exchanger filters (HMEF), used for humidification of patient respiratory gas and filtering microorganisms can cause airway obstruction. We experienced serious airway obstruction in a HMEF after making hydrothorax for high intensity focused ultrasound (HIFU) procedure. The airway obstruction was difficult to differentiate from severe bronchospasm irresponsive to bronchodilator therapy. It was relieved dramatically after we removed the filter from the breathing circuit as soon as we detected air-fluid meniscus in it. (Anesth Pain Med 2011; 6: 96∼99)

참고문헌 (Reference)

1 정채인, "가열호흡회로 내 증류수로 인한 열/습도 교환기 폐쇄 일례" 대한마취과학회 57 (57): 358-360, 2009

2 Iotti GA, "Unfavorable mechanical effects of heat and moisture exchangers in ventilated patients" 23 : 399-405, 1997

3 Williams DJ, "Rapid and complete occlusion of a heat and moisture exchange filter by pulmonary edema (clinical report)" 49 : 126-131, 2002

4 Sibai AN, "Progressive hypoxemia, hypercarbia and hyperthermia associated with prolonged anesthesia--a case report" 19 : 527-536, 2007

5 Kopman AF, "Obstruction of bacterial filters by edema fluid" 44 : 169-170, 1976

6 Aarhus D, "Mechanical obstruction in the anaesthesia delivery-system mimicking severe bronchospasm" 52 : 992-994, 1997

7 Jaber S, "Long-term effects of different humidification systems on endotracheal tube patency: evaluation by the acoustic reflection method" 100 : 782-788, 2004

8 Smith CE, "Bilateral tension pneumothorax due to a defective anesthesia breathing circuit filter" 3 : 229-234, 1991

9 Yao CL, "Anaesthesia for high intensity focused ultrasound (HIFU) therapy" 63 : 865-872, 2008

10 Morgan-Hughs NJ, "Air flow resistance of three heat and moisture exchanging filter designs under wet conditions: implications for patient safety" 87 : 289-291, 2001

11 Shelly MP, "A review of the mechanisms and methods of humidification of inspired gases" 14 : 1-9, 1988

12 Prados W, "A dangerous defect in a heat and moisture exchanger" 71 : 804-, 1989