Effect of the humidification device on the work of breathing during noninvasive ventilation

Lellouche, François; Maggiore, Salvatore Maurizio; Deye, Nicolas; Taillé, Solenne; Pigeot, Jérôme; Harf, Alain; Brochard, Laurent

doi:10.1007/s00134-002-1518-9

Cited by 125 publications

(90 citation statements)

References 42 publications

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“…It has been shown that, in acute studies [19,20] and compared to HH, the HME may significantly increase dead space, work of breathing and carbon dioxide retention during an episode of acute respiratory failure requiring NIMV treatment, and this may also interfere with triggering functioning. Acute changes in Pa,CO 2 during NIMV may not predict a chronic effect, as demonstrated, for example, by HILL et al [21].…”

Section: Discussionmentioning

confidence: 99%

Comparison of two humidification systems for long-term noninvasive mechanical ventilation

Nava¹,

Cirio²,

Fanfulla³

et al. 2008

European Respiratory Journal

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There is no consensus concerning the best system of humidification during longterm noninvasive mechanical ventilation (NIMV).In a technical pilot randomised crossover 12-month study, 16 patients with stable chronic hypercapnic respiratory failure received either heated humidification or heat and moisture exchanger. Compliance with long-term NIMV, airway symptoms, side-effects and number of severe acute pulmonary exacerbations requiring hospitalisation were recorded.Two patients died. Intention-to-treat statistical analysis was performed on 14 patients. No significant differences were observed in compliance with long-term NIMV, but 10 out of 14 patients decided to continue long-term NIMV with heated humidification at the end of the trial. The incidence of side-effects, except for dry throat (significantly more often present using heat and moisture exchanger), hospitalisations and pneumonia were not significantly different.In the present pilot study, the use heated humidification and heat and moisture exchanger showed similar tolerance and side-effects, but a higher number of patients decided to continue long-term noninvasive mechanical ventilation with heated humidification. Further larger studies are required in order to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Comparison of two humidification systems for long-term noninvasive mechanical ventilation

Nava¹,

Cirio²,

Fanfulla³

et al. 2008

European Respiratory Journal

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“…Lellouche et al 79 reported that minute ventilation was significantly higher with an HME than with heated humidifier for a similar P aCO 2 . Moreover, the HME was associated with a greater increase in work of breathing and indexes of patient effort.…”

Section: The Humidifier and Asynchronymentioning

confidence: 95%

Patient-Ventilator Interaction During Noninvasive Ventilation

Hess

2011

Respir Care

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There is arguably more evidence to support the use of noninvasive ventilation (NIV) than any other practice related to the care of patients with acute respiratory failure. Despite this strong evidence base, NIV seems to be under-utilized and the failure rate (need for intubation) may be as high as 40%. Some of these failures potentially relate to asynchrony, although the relationship between asynchrony and NIV failure has not been well studied. Good NIV tolerance has been associated with success of NIV, and improved comfort has been associated with better synchrony. In one study a high rate of asynchrony occurred in 43% of patients during NIV. Asynchrony is commonly associated with leaks. Thus, reducing the leak related to the interface and using a ventilator with good leak compensation should reduce the rate of asynchrony. Asynchronies can also be related to the underlying disease process. This paper reviews issues related to asynchrony during NIV and suggests strategies that might be used to correct asynchrony when it occurs.

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“…In addition, bronchial mucosa may be injured by dry gas with dry secretions difficult to cough. Heated humidifiers are usually preferred to HMI that offer more inspiratory resistances and dead space in NIV (5,6).…”

Section: Equipmentmentioning

confidence: 99%

How to implement NIV in the ICU?

Arnal¹

2012

AML

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NIV is widely used in the ICU for different types of respiratory failure. However, there is no recommendation on the method to implement successfully the NIV program in the ICU. The three keys are equipment, caregiver's education and training, and organisation. Equipment should be considered purchasing the appropriate ventilators according to the number of patients and the type of patients admitted. Interface selection is very important and should not be neglected. Humidification devices should also be appropriate. Physician, nurses and respiratory therapist have to get education, practical training and a continuous training program. Organisation of NIV in the ICU is improved if there is a local developed protocol with precise indication criteria, initiation method, mask selection, ventilator settings, NIV session duration and monitoring.

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Effect of the humidification device on the work of breathing during noninvasive ventilation

Abstract: In patients receiving NIV for moderate to severe acute hypercapnic respiratory failure, the use of HME lessens the efficacy of NIV in reducing effort compared to HH.

Cited by 125 publications

References 42 publications

Comparison of two humidification systems for long-term noninvasive mechanical ventilation

Comparison of two humidification systems for long-term noninvasive mechanical ventilation

Patient-Ventilator Interaction During Noninvasive Ventilation

How to implement NIV in the ICU?

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