Efficacy of a heat and moisture exchanger in inhalation anesthesia at two different flow rates

In general anesthesia with endotracheal intubation, a circle system with a heat and moisture exchanger (HME) and a low total flow is often used to prevent hypothermia and to maintain inspired gas humidity. The purpose of the present study was to compare the inspired gas humidity and body temperature, in general anesthesia with or without an HME at two different total flow rates. Eighty patients (American Society of Anesthesiologists [ASA] I or II) scheduled to undergo either orthopedic or head and neck surgery were studied. They were divided into four groups, of 20 patients each: total flow of 2 lxmin(-1) with (group HME2L) or without (group 2L) HME, and a total flow of 4 lxmin(-1) with (group HME4L) or without (group 4L) HME. The relative and absolute humidity and pharyngeal and inspired gas temperatures were measured for 2 h after endotracheal intubation. The relative humidity was not significantly different among groups 2L, HME2L, and HME4L. Group 4L had significantly lower absolute humidity than group 2L. The pharyngeal temperature did not decrease significantly for 2 h in any of the groups. During general anesthesia with a total flow of 2 lxmin(-1) in 2 h, HME might not be necessary, while with a total flow of 4 lxmin(-1), HME could be useful to maintain inspired gas humidity.