One previous study was conducted to evaluate the effect of humidi-filters on dead space in pediatric patients. Even when used in patients that are healthy without acute lung disease, smaller pediatric patients would be affected by the use of a pediatric HME.
The volume of a pediatric HME is generally 20-25 ml, which is about 1/10 of the tidal volume of a 20 kg patient or 1/5 for a 10 kg patient. However, with the exception of extremely small premature neonates, most pediatric patients undergoing general anesthesia are applied with only one size of pediatric HME between the tracheal adaptor and the Y piece. Therefore, most studies to evaluate the dead space effect of HME in adult patients have been conducted in ICU patients receiving lung protective ventilation with a lower tidal volume of 4-6 ml/kg. HME have a low resistance to airway flow and a relatively small volume (about 75 ml), which is not too large to impair ventilation of healthy adult patients ventilated with a tidal volume of 8-12 ml/kg. Heat-and-moisture exchangers (HME) are the most commonly used humidi-filters.
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