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Liver, GI and Metabolism
Published in Sarah Armstrong, Barry Clifton, Lionel Davis, Primary FRCA in a Box, 2019
Sarah Armstrong, Barry Clifton, Lionel Davis
ManagementABC, invasive monitoring ■ treat hypoxia, hypoventilation and acidosis ■ investigate the causerewarm patient – rapidly if rapid onset of hypothermia, slowly if insidious onset non-invasive – blankets, radiant heaters, heat and moisture exchangerinvasive – warmed IV fluids, peritoneal dialysis or bladder irrigation and possibly cardiopulmonary bypass, if available
Paediatric Tracheostomy
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Initially, humidification should be given via nebulizers and a tracheostomy mask. After a week or so, secretions reduce and the level of humidification required is less. A few weeks after tracheostomy, more mobile devices can replace permanent humidification. Longer-term humidification may be achieved by using a Swedish nose or a tracheostomy bib (Figure 35.7). A heat and moisture exchanger (HME or ‘Swedish nose’) attachment (Figure 35.8) contains a filter which becomes saturated by the moisture in exhaled air; this in turn humidifies the inhaled air. The tracheal bib works in a similar way. Both devices have the advantage of acting as filters for inspired air.
Techniques: General
Published in Brian J Pollard, Gareth Kitchen, Handbook of Clinical Anaesthesia, 2017
Baha Al-Shaikh, Sanjay Agrawal, Sindy Lee, Daniel Lake, Nessa Dooley, simon Stacey, Maureen Bezzina, Gregory Waight
CO2 absorption by soda lime or baralyme is an exothermic reaction resulting in heat and water vapour formation. The humidity generated by the reaction makes the use of a heat and moisture exchanger unnecessary.
Anesthetic management of obstetric patients with COVID-19: A scoping review
Published in Egyptian Journal of Anaesthesia, 2022
Radwa Hamdi Bakr Mohamed, Waad Al-Ghamdi, Aldanah Al-Marri, Bayan Al-Abdullah, Nebras Al-Hajji, Alkawthar Al-Shaybe
Additionally, Harenberg et al., (2020) recommended that the anesthesia machine should be fitted with a heat and moisture exchanger between the circuit and the patient’s airway to prevent the virus from entering the internal parts of the machine and to subsequently prevent pathogen transmission to other patients [19]. Furthermore, Al Harbi et al., (2021) highlighted the importance of hand hygiene before and after coming into touch with the anesthesia system and equipment as well as shielding the anesthesia system and other work surfaces with disposable plastic covers. The authors also advocated the use of disposable or single-patient tracking devices wherever possible (e.g., pulse oximeter, BP cuff, etc.) [20]. Similarly, Chhabra et al., (2020) stated that anesthesia providers should wear three layers of gloves which include sterile gloves on top of the two pairs provided by PPE [21]. Again, Martinez et al., (2020) and Du et al., (2020) recommended the use of full airborne precautions when providing general anesthesia for cesarean section in patients infected with COVID-19. This includes filtering face-piece type 3, eye cover, apron, fluid-resistant disposable gown, and gloves. When cesarean section was performed under neuraxial anesthesia, the authors recommended droplet precautions while assessing the risk of conversion to general anesthesia. [22,23]
Development challenges and opportunities in aerosol drug delivery systems in non-invasive ventilation in adults
Published in Expert Opinion on Drug Delivery, 2019
Gregory Reychler, Jean-Bernard Michotte
As the upper airways are bypassed during mechanical ventilation, the circuits connected to the ventilators are humidified in clinical practice. The way of humidification (heated humidifier, heat and moisture exchanger) impacts differently the air dryness [24]. It is well-known that the humidity level of the circuit of the ventilator modifies the drug delivery. Based on physical mechanism, an increase in the humidity and the associated increase of the particles size reduce the lower respiratory drug delivery by nebulization.
Lifestyle and rehabilitation during the COVID-19 pandemic: guidance for health professionals and support for exercise and rehabilitation programs
Published in Expert Review of Anti-infective Therapy, 2021
Cássia Da Luz Goulart, Rebeca Nunes Silva, Murilo Rezende Oliveira, Solange Guizilini, Isadora Salvador Rocco, Vanessa Marques Ferreira Mendez, José Carlos Bonjorno, Flavia Rossi Caruso, Ross Arena, Audrey Borghi-Silva
In relation to intra-hospital transport, HCPs must use PPE (Level Il Protection) [90]. Patients who are not on mechanical ventilation should wear a surgical mask; however, for those on mechanical ventilation, a Heat and Moisture Exchanger filter in the endotracheal tube and High Efficiency Particulate Arrestance filter in the ventilator’s expiratory valve is recommended. Avoid unnecessary disconnections, and, if deemed necessary, disconnect with the endotracheal tube clamped.