전신마취 시 사용한 열선내장형 가온 가습 호흡회로의 비교평가 = Clinical Research Article : A comparative evaluation of humidifier with heated wire breathing circuit under general anesthesia

다국어 초록 (Multilingual Abstract)

Background: Dry and cold anesthetic gas deteriorates patient`s respiratory function and body heat balance. We examined whether a humidifier with heated wire circuit might maintain core temperature and humidity of inspired gas in patient undergoing general anesthesia. Methods: We enrolled forty ASA physical status I, II patients under general anesthesia for this study. We allocated the patients randomly into two groups with (experimental group) or without (control group) Humitube(R) anesthesia circuit, which delivered heated and humidified inspired anesthetic gases. We recorded the temperatures and humidity of the inspired gases throughout the surgery. Results: The temperatures and relative humidity of the inspired gases in experimental group were significantly greater compared to control group (36.2±0.9℃, 89.5±4.8% vs. 30.4±1.8℃, 37.9±5.9%, P＜0.05) during anesthesia. The core temperatures in experimental group were significantly greater compared to control group (36.1±0.3℃ vs. 35.7±0.1℃, P＜0.05) during anesthesia. Conclusions: A humidifier with heated wire system for anesthesia breathing circuit is helpful to maintain core temperature and adequate humidity. (Korean J Anesthesiol 2009; 57: 32~7)

참고문헌 (Reference)

1 Gendron F, "“Burns” occurring during lengthy surgical procedures" 5 : 19-26, 1980

2 Coté CJ, "Wasted ventilation measured in vitro with eight anesthetic circuits with and without inline humidification" 59 : 442-446, 1983

3 Sessler DI, "Temperature monitoring and perioperative thermoregulation" 109 : 318-338, 2008

4 Miyao H, "Relative humidity, not absolute humidity, is of great importance when using a humidifier with a heating with a heating wire" 20 : 674-679, 1992

5 Williams R, "Relationship between the humidity and temperature of inspired gas and the function of the airway mucosa" 24 : 1920-1929, 1996

6 Kurz A, "Postoperative hemodynamic and thermoregulatory consequences of intraoperative core hypothermia" 7 : 359-366, 1995

7 Kurz A, "Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of wound infections and temperature group" 334 : 1209-1215, 1996

8 Frank SM, "Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial" 277 : 1127-1134, 1997

9 Sessler DI, "Perianesthetic thermoregulation and heat balance in humans" 7 : 638-644, 1993

10 Just B, "Oxygen uptake during recovery following naloxone. Relationship with intraoperative heat loss" 76 : 60-64, 1992

11 Sessler DI, "Mild perioperative hypothermia" 336 : 1730-1737, 1997

12 Lenhardt R, "Mild intraoperative hypothermia prolongs postoperative recovery" 87 : 1318-1323, 1997

13 Schmied H, "Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty" 347 : 289-292, 1996

14 Tausk HC, "Maintenance of body temperature by heated humidification" 55 : 719-723, 1976

15 Hynson JM, "Intraoperative warming therapies: a comparison of three devices" 4 : 194-199, 1992

16 Bissonnette B, "Intraoperative temperature monitoring sites in infants and children and the effect of inspired gas warming on esophageal temperature" 69 : 192-196, 1989

17 Bengtson JP, "Humidity of the Bain and circle systems reassessed" 69 : 83-86, 1989

18 Seung IS, "Humidity of inspired gases in partial rebreathing anesthesia method with and without Bird humidifier" 36 : 387-391, 1999

19 Martin C, "Heat and moisture exchangers and vaporizing humidifiers in the intensive care unit" 97 : 144-149, 1990

20 Melling AC, "Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomized controlled trial" 358 : 876-880, 2001

21 Chalon J, "Effects of dry anesthetic gases on tracheobronchial ciliated epithelium" 37 : 338-343, 1972

22 Yoon SM, "Effect of six heated and moisture exchangers for use during endotracheal anesthesia" 22 : 437-441, 1989

23 Branson RD, "Anesthesia circuits, humidity output, and mucocilliary structure and function" 26 : 178-183, 1998

24 Schiffmann H, "Airway humidification in mechanically ventilated neonates and infants: a comparative study of a heat and moisture exchanger vs. a heated humidifier using a new fast-response capacitive humidity sensor" 25 : 1755-1760, 1997

25 Winkler M, "Aggressive warming reduces blood loss during hip arthroplasty" 91 : 978-984, 2000

26 Stone DR, "Adult body temperature and heated humidification of anesthetic gases during general anesthesia" 60 : 736-741, 1981