Fresh Gas Flows, Filters, HMEs and Humidification

I recently submitted a “Letter to the Editor” of the BJA in response to the clever¬†study by Zhong and colleagues demonstrating that the use of high fresh gas flows (FGF) during TIVA produces a cost-saving with, importantly, no adverse environmental consequences. My letter was responding to their conclusion regarding the impact of high FGFs on humidification of inhaled gases, and specifically the issue of heat and moisture exchangers (HMEs).

The letter was edited and shortened significantly during the review process, so much so that I felt some important discussion around a commonly misunderstood device was missing. The published letter is now available here,  but I felt it might be helpful to make the full text of the original letter (with some minor corrections) publicly available, so I have presented it below.

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