Humidity of Anaesthetic Gases with Respect to Low Flow Anaesthesia

Abstract

It has been demonstrated in an experimental study in swine using the scanning electron microscope that a rebreathing technique utilising minimal fresh gas flowrates significantly improves climatization of anaesthetic gases. Consequently, effects of various anaesthetic techniques on airway climate must be assessed, which covers the need for suitable measuring devices. Basic principles and methods of humidity measurement in flowing anaesthetic gases include gravimetric hygrometry, dew point hygrometry, wet-dry bulb psychrometry, mass spectrometry, spectroscopic hygrometry and electrical hygrometry. A custom-made apparatus for continuous measurement of humidity and temperature in the inspired and expired gas mixtures of a breathing circuit (separated by a valve system, integrated between the endotracheal tube and the Y-piece) is described. Comparative evaluation of this apparatus and the psychrometer was carried out. It could be demonstrated that the apparatus, measuring with capacitive humidity sensors, is more suitable for prolonged use under clinical conditions than the psychrometer. In the second part of the study, climatisation of anaesthetic gases under clinical conditions was investigated using fresh gas flowrates of 0.6, 1.5, 3.0 and 6.0 l/min. In the inspiratory limb of the circuit an absolute humidity of 21.3 mg H2O/l and a temperature of 31.5 °C were obtained after 120 minutes of minimal flow. Humidity and temperature of inspired air obtained with fresh gas flowrates of 6.0 and 3.0 l/min were found to be inadequate for prolonged anaesthesia. Reducing the fresh gas flow to 1.5 l/min increases heat and moisture content in the respired gases, but conditions are still inadequate for prolonged anaesthesia. Sufficient moisture (≥20 mg H2O/l) and temperature are obtained under minimal flow conditions after one hour.