StandardsDESIGN HISTORY, REFERENCES & PUBLICATIONS
Historical development of the Humphrey ADE-circle system with references and publications by the designer and independent researchers.
1983:
- Introduction of the concept of the multipurpose ADE system - two lever version
- Pressure-limiting device added to a breathing system for the first time
1984:
- The simplification of the ADE system to a single lever
- Safety achieved by being instantly switchable to all modes of use
- Safety locking device for lever added
- Manual ventilation in the "A" mode observed to be efficient
- Independent confirmation that lower than expected fresh gas flows (46ml/kg/min) were safe and that the ADE was more efficient than the Magill
1986:
- Full clinical assessment of the ADE system by the author
- Low fresh gas flow for spontaneous respiration recommended at 50 ml/kg/min
- Confirmed efficient function during IPPV
1987:
- Introduction of the use of the ADE system for children
- Low fresh gas flows of an average of 2 l/min in children (one third of the T-piece)
- Pollution problems in paediatrics resolved
- Further independent confirmation that the ADE system requires low fresh gas flows (52 ml/kg/min) for spontaneous respiration in adults
1989:
- ADE independently confirmed again to be the most efficient system for spontaneous respiration in a model lung
1991:
- Independent confirmation of advantages of the ADE system over the T-piece from The Hospital for Sick Children, Great Ormond Street, London (GOS)
- 3 l/min recommended for children with a considerable margin of safety by GOS
1992:
- Smaller 15mm smooth-bore tubing recommended to be suitable for both children and adults as resistance to flow was significantly less than standard tubes.
- The use of the ADE system shown to provide a relatively pollution-free environment in dental practice
- Independent confirmation that the ADE system in the "A" mode was efficient for manual ventilation.
1993:
- Introduction of a innovative exhaust valve for paediatric use offering the benefits of "PEEP" but with minimal resistance
- Improved safety due to new visible function of this new valve
- Manual ventilation with new valve without closing it
1994:
- summary of all evidence concerning the increased efficiency of the ADE system over the Magill for spontaneous respiration.
1997-9:
- extending the options of the ADE system to include re-cycling
- the design of the new soda lime canister - advantages of a canister in "parallel" rather than in "series"
- greater control and safety with fast response times within the ADE-circle
References: chronological order
Humphrey D
- Humphrey D:
A new anaesthetic breathing system combining Mapleson A, D and E principles: a simple apparatus for low flow universal use without carbon dioxide absorption. Anaesthesia 1983; 38: 361-72 -
Humphrey D:
The ADE anaesthetic breathing system:
Anaesthesia 1984: 39: 715-6
-
Humphrey, D, Brock-Utne JG, Downing JW:
Single lever Humphrey A.D.E. low flow universal anaesthetic breathing system.
Part 1. comparison with dual lever A.D.E., Magill and Bain systems in anaesthetized spontaneously breathing adults.
Part II: comparison with Bain system in anaesthetized adults during controlled ventilation.
Canad. J. Anaesth. 1987; 33: 698-709 and 710-18. -
Humphrey D, Brock-Utne JG:
Suggested solutions to the problem of the T-piece anaesthetic breathing system:
Canad Anaesth Soc J 1987; 34: S129. -
Humphrey D.
Manual ventilation and the Humphrey ADE breathing system.
Anaesthesia 1992; 47: 625. -
Humphrey D.
Use of 15mm tubing with the Humphrey ADE breathing system.
Anaesthesia 1992; 47: 639-40. -
Humphrey D.
Eliminating pollution in paediatric and dental anaesthesia
Anaesthesia 1992; 47: 640-1. -
Humphrey D:
An efficient pollution-free paediatric breathing system
Annual Scientific meeting of the Association of Anaesthetists, Glasgow 1993, Book of Abstracts, page 29. -
Humphrey D:
Mapleson "A" systems - can recent modifications improve on the efficiency of the Magill?
Annual Scientific meeting of the Association of Anaesthetists, Brighton 1994, Book of Abstracts, page 6-7. -
Humphrey D:
The Humphrey ADE-circle system - Poster
Predictable carbon dioxide tensions during controlled ventilation in a circle system.
Annual Scientific meeting of the Association of Anaesthetists, Harrogate 1997, Book of Abstracts, page 12.
Independent authors:
- Dixon J, Chakrabarti MK, Morgan M.
An assessment of the Humphrey ADE anaesthetic system in the Mapleson A mode during spontaneous ventilation.
Anaesthesia 1984; 39: 593-6. -
Shulman MS, Brodsky JB
The A.D.E. system - a new anesthetic breathing system
Anesth Analg 1984; 63: 273. -
Artru AA, Katz RA.
Evaluation of the Humphrey A.D.E. system
Canad J Anaesth 1987; 34: 484-8. -
Chan Ash, Bruce WE, Soni N:
A comparison of anaesthetic breathing systems during spontaneous ventilation; an in-vitro study using a model lung.
Anaesthesia 1989; 44: 194-99. -
Orlikowski CEP, Ewart MC, Bingham RM.
The Humphrey ADE system: Evaluation in paediatric use.
Br J Anaesth 1991; 66: 253-7. -
Nott MR, Briffa AC.
The Humphrey ADE, Magill and Lack breathing systems.
Anaesthesia 1992; 47: 1105-6.
Books:
- Ward's Anaesthetic Equipment:
see sections on anaesthetic equipment including the paediatric section -
Handbook of Paediatric Anaesthesia.
see sections on anaesthetic equipment
Review articles:
- Humphrey D.
A simple, safe and efficient anaesthetic breathing system for universal use in rural environments.
Tropical Doctor 1995. 25 (suppl 1), 34-39 -
Humphrey D.
The Humphrey multipurpose anaesthetic breathing system; a novel, economical and simple circuit with or without re-cycling
Postgraduate Doctor. Caribbean Edn; 13, No 4, p168-178 and African Edn; 19, No 3, 56-64.