Conditioning of the inspired gas

The upper airways, including the nose, condition the inspired gas so that it is heated to body temperature, humidified so that the water saturation is 100 per cent, and filtered to remove larger particles. This will not occur in the intubated patient unless a heat-moisture exchanger or humidifier is connected to the breathing circuit. If the patient is receiving an unconditioned gas, the airways will dry and be more susceptible to infection. A heat-moisture exchanger will reduce fluid loss by condensation of water vapor on the surfaces in the exchanger and evaporation of fluid with the next inspiration. The loss can be completely compensated by more efficient humidifiers based on ultrasonic or heat evaporation principles, and a net inflow of water or water vapor can occur to the extent that interstitial edema may develop.

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