2007 · INTENSIVE CARE MEDICINE

Airway humidification with a heat and moisture exchanger in mechanically ventilated neonates

Fassassi, Mikaila, Michel, Fabrice, Thomachot, Laurent, Nicaise, Claire, Vialet, Renaud, Jammes, Yves, Lagier, Pierre, Martin, Claude

Journal
INTENSIVE CARE MEDICINE
Année
2007
Volume
33
Numéro
2
Pages
336-343
Mois
FEB
DOI
10.1007/s00134-006-0466-1

Abstract

Objective: We set out to evaluate the efficacy of passive inspiratory gas conditioning in mechanically ventilated neonates and compared it with that of a heated humidifier (HH). Design: Prospective, randomized, controlled study. Setting: Neonatal and pediatric intensive care unit. Patients: Fourteen mechanically ventilated neonates nursed in incubators. Interventions: The HH was set to deliver a temperature of 37 degrees C and an absolute humidity of 40 mgH(2)O/l at the incubator entrance. Inspired temperature (T degrees) and absolute humidity (AH) were measured by the psychometric method, transpulmonary pressure (Tpres) by means of a differential pressure transducer. Measurements were performed at 5, 10, and 15 min. Measurements and results: The values of T degrees were significantly higher using the HH (34.6 +/- 1.6 degrees C) than the heat and moisture exchanger (HME) (33.8 +/- 2.3, p < 0.001). The values of AH were significantly higher using the HH (36.6 +/- 2.5 mgH(2)O/l) than the HME (32.4 +/- 2.8 mgH(2)O/l, p < 0.001). No significant changes were observed in transpulmonary pressure. A significant positive correlation was observed between incubator temperature and the temperature delivered by the HH (R-2 = 0.61, p < 0.001). Conclusions: The use of HMEs in neonates made it possible to achieve an absolute humidity of 28 mgH(2)O/l or more and a temperature of 30 degrees C or more. Higher values are obtained using a HH.

Lire l'article complet