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We thank for that valuable comment on our article “Positive end-expiratory pressure valve malfunctioning detected by capnographic and airway pressure waveform.”
We would like to point out that we use an Heat Moisture Exchanger (HME) filter at the inspiratory (filter on Y piece) and the expiratory port for all our patients. According to the company (Drager Medical) for disinfection/cleaning/autoclaving for adjustable pressure limiting valves it is mentioned (as per the instruction manual) that in noninfectious patients when a filter is used for inspiratory and expiratory port, the washing with detergent and wet pasteurization/immersion in cidex/autoclaving should be done on a weekly basis and not after each patient use as per the response.
As per this recommendation the cleaning was carried out according to schedule. Furthermore, the servicing by the company was as per the annual maintenance contract.