Measurement of flow-resistive work of heat and moisture exchangers during simulated active breathing

The performance of seven commercially available heat and moisture exchangers (HME) was evaluated in the dynamic flow state. A piston pump was used as a simulator with operative conditions with stroke volume of 500 ml and with respiratory rates of 20 and 40 cycles.min-1. A pressure-volume loop was produced for each HME and the flow-resistive work calculated. Each HME was studied under both dry and wet conditions. It was found that the flow-resistive work of the Humid-Vent 2 was the smallest and that of the Breathaid the largest under both conditions. The results suggest that application of HME causes a significant increase in resistance and demands a greater breathing effort from patients. Its use should thus be avoided in marginal patients.