The Humphrey ADE system: evaluation in paediatric use.

Area of Science:

• Anesthesiology
• Pediatric Critical Care
• Respiratory Support Devices

Background:

• The Humphrey ADE single lever parallel form breathing system is a device used in pediatric respiratory support.
• Evaluating its performance in mechanically ventilated and spontaneously breathing children is crucial for clinical application.

Purpose of the Study:

• To assess the efficacy and safety of the Humphrey ADE breathing system in pediatric patients.
• To compare its performance against established breathing circuits like the Jackson-Rees modification of Ayre's T-piece.

Main Methods:

• The study involved 17 children requiring mechanical ventilation and 10 spontaneously breathing children.
• Performance was evaluated in different modes: controlled ventilation (E mode) and hand ventilation (A mode).
• Fresh gas flow (FGF) rates and end-tidal partial pressure of carbon dioxide (PETCO2) were measured.

Main Results:

• During controlled ventilation (E mode), the ADE system's performance was comparable to the T-piece circuit with standard or weight-based FGF.
• In hand ventilation (A mode), mean PETCO2 was 5.3 kPa, and no rebreathing occurred in spontaneously breathing patients at 3 L/min FGF.
• Rebreathing during spontaneous breathing in A mode began at 124 ml/kg/min FGF.

Conclusions:

• The Humphrey ADE circuit demonstrated satisfactory performance across all evaluated modes in pediatric patients.
• For controlled ventilation (E mode), FGF adjustment should follow T-piece circuit recommendations.
• For hand ventilation (A mode), a FGF exceeding 3 L/min is advised.