Assessment of Humidification Performance: Still No Easy Method!

Cuquemelle, E.; Lellouche, François

doi:10.4187/respcare.02761

Cited by 10 publications

(9 citation statements)

References 15 publications

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“…As discussed previously, it is difficult to measure humidification correctly. 8 In addition, the environmental conditions differed. At Ͻ100% relative humidity, absolute humidity is dependent on inspiratory gas temperature.…”

Section: Discussionmentioning

confidence: 99%

Humidification Performance of Passive and Active Humidification Devices Within a Spontaneously Breathing Tracheostomized Cohort

et al. 2018

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BACKGROUND: Most heat-and-moisture exchangers (HMEs) for patients with tracheostomy and spontaneously breathing are small and have suction ports that allow some expiratory gas to escape, which loses water vapor held in the expired gas. Recently, a heated-and-humidified high-flow system for spontaneously breathing patients with tracheostomy was developed. Little is known, however, about the humidifying performance of HMEs or heated-and-humidified high-flow systems for spontaneous breathing patients with a tracheostomy. OBJECTIVE: To investigate the humidifying performance of the HMEs and heated-and-humidified high-flow systems for spontaneously breathing patients with tracheostomy. METHODS: Adult spontaneously breathing subjects with tracheostomy and were enrolled when their respiratory parameters and S pO 2 were stable. We measured absolute humidity, relative humidity, and temperature by using a capacitance-type moisture sensor at the outlet of the tracheostomy tube. Heated-and-humidified high flow was delivered via the a humidifier and tracheostomy interface, and a selected HME. The subjects received heated-and-humidified high flow, after which an HME was used for humidification before switching back to a heated-and-humidified high-flow system. RESULTS: Ten subjects (5 men, 5 women; mean ؎ SD age, 72 ؎ 12 y) were enrolled. The admission diagnoses were neurologic (5 subjects), respiratory failure (3), and cardiac arrest (2). The APACHE (Acute Physiology and Chronic Health Evaluation) II score was 24 (interquartile range, 20-27). Tracheostomy was performed on day 7 (interquartile range, 5-11 d) after endotracheal intubation, and the duration of mechanical ventilation was 10 d (interquartile range, 6-11 d). The temperature with the HME was 29.9 ؎ 1.0°C and, during heated-and-humidified high-flow use was 35.3 ؎ 0.8°C (P < .001). With both the HME and the heated-and-humidified high-flow system, the relative humidity reached 100%; the absolute humidity with HME was 30.2 ؎ 1.8 mg/L, and, with the heated-and-humidified high-flow system, was 40.3 ؎ 1.8 mg/L (P < .001). CONCLUSIONS: In spontaneously breathing subjects with tracheostomy, an heated-and-humidified high-flow system achieved higher absolute humidity than did an HME.

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Section: Discussionmentioning

confidence: 99%

Humidification Performance of Passive and Active Humidification Devices Within a Spontaneously Breathing Tracheostomized Cohort

et al. 2018

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“…High‐flow nasal oxygen therapy delivers warmed humidified oxygen and low level, flow‐dependent positive airways pressure, and may be better tolerated than CPAP or non‐invasive ventilation; moreover, high‐flow nasal oxygen enhances washout of nasopharyngeal dead space, thus improving oxygenation . It has been shown that high‐flow nasal oxygen is both safe and non‐inferior to conventional CPAP in providing prophylactic support to very preterm neonates after extubation while the incidence of nasal trauma was significantly lower than in the CPAP group .…”

Section: Introductionmentioning

confidence: 99%

The effect of high‐flow nasal oxygen on hospital length of stay in cardiac surgical patients at high risk for respiratory complications: a randomised controlled trial

et al. 2018

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SummaryThere has been increased interest in the prophylactic and therapeutic use of high‐flow nasal oxygen in patients with, or at risk of, non‐hypercapnic respiratory failure. There are no randomised trials examining the efficacy of high‐flow nasal oxygen in high‐risk cardiac surgical patients. We sought to determine whether routine administration of high‐flow nasal oxygen, compared with standard oxygen therapy, leads to reduced hospital length of stay after cardiac surgery in patients with pre‐existing respiratory disease at high risk for postoperative pulmonary complications. Adult patients with pre‐existing respiratory disease undergoing elective cardiac surgery were randomly allocated to receive high‐flow nasal oxygen (n = 51) or standard oxygen therapy (n = 49). The primary outcome was hospital length of stay and all analyses were carried out on an intention‐to‐treat basis. Median (IQR [range]) hospital length of stay was 7 (6–9 [4–30]) days in the high‐flow nasal oxygen group and 9 (7–16 [4–120]) days in the standard oxygen group (p=0.012). Geometric mean hospital length of stay was 29% lower in the high‐flow nasal group (95%CI 11–44%, p = 0.004). High‐flow nasal oxygen was also associated with fewer intensive care unit re‐admissions (1/49 vs. 7/45; p = 0.026). When compared with standard care, prophylactic postoperative high‐flow nasal oxygen reduced hospital length of stay and intensive care unit re‐admission. This is the first randomised controlled trial examining the effect of prophylactic high‐flow nasal oxygen use on patient‐centred outcomes in cardiac surgical patients at high risk for postoperative respiratory complications.

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“…Most trials evaluating the efficacy of active humidification systems (external humidifiers) focus on measures of tracheal temperature gradients, relative and absolute humidity as a measure of efficacy, which was not included as one of the primary outcome measures of this review. 8,9,20 There are a number of current guidelines and reports in the UK such as the Intensive Care Society (ICS) 2014 revised guidelines, the National Tracheostomy Safety Project (NTSP) that relates to overall tracheostomy care and general choice of humidification in neck breather patients. 21 In the context of critical care, heated humidification is most commonly used despite a lack of consensus about the ideal means of providing humidification, which is usually a bedside decision based on patient specific factors.…”

Section: Discussionmentioning

confidence: 99%

Active versus passive humidification for self-ventilating tracheostomy and laryngectomy patients: A systematic review of the literature

Wong

Shakir

Farboud

et al. 2016

International Journal of Surgery

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Assessment of Humidification Performance: Still No Easy Method!

Cited by 10 publications

References 15 publications

Humidification Performance of Passive and Active Humidification Devices Within a Spontaneously Breathing Tracheostomized Cohort

Humidification Performance of Passive and Active Humidification Devices Within a Spontaneously Breathing Tracheostomized Cohort

The effect of high‐flow nasal oxygen on hospital length of stay in cardiac surgical patients at high risk for respiratory complications: a randomised controlled trial

Active versus passive humidification for self-ventilating tracheostomy and laryngectomy patients: A systematic review of the literature

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