Encuesta sobre humidificación de la vía aérea en unidades de cuidados intensivos de adultos de Chile

Retamal, Jaime; Castillo, Juan Sebastián; Bugedo, Guillermo; Bruhn, Alejandro

doi:10.4067/s0034-98872012001100007

Cited by 3 publications

(1 citation statement)

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“…During spontaneous breathing, inspiratory gases are usually heated and humidified in the nasal cavity and pharynx [ 2 ]. The normal physiology of conditioning gas is altered when the patient requires an artificial airway, intubation eliminates the natural mechanisms of filtration, humidification, and warming of inspired air [ 3 ]. The humidification of inspired gas is mandatory for all mechanically ventilated patients, however, the debate about the ideal humidification continues today [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Humidification on Ventilated Patients: Heated Humidifications or Heat and Moisture Exchangers?

Cerpa¹,

Cáceres²,

Romero-Dapueto³

et al. 2015

TORMJ

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The normal physiology of conditioning of inspired gases is altered when the patient requires an artificial airway access and an invasive mechanical ventilation (IMV). The endotracheal tube (ETT) removes the natural mechanisms of filtration, humidification and warming of inspired air. Despite the noninvasive ventilation (NIMV) in the upper airways, humidification of inspired gas may not be optimal mainly due to the high flow that is being created by the leakage compensation, among other aspects. Any moisture and heating deficit is compensated by the large airways of the tracheobronchial tree, these are poorly suited for this task, which alters mucociliary function, quality of secretions, and homeostasis gas exchange system. To avoid the occurrence of these events, external devices that provide humidification, heating and filtration have been developed, with different degrees of evidence that support their use.

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Section: Introductionmentioning

confidence: 99%

Humidification on Ventilated Patients: Heated Humidifications or Heat and Moisture Exchangers?

Cerpa¹,

Cáceres²,

Romero-Dapueto³

et al. 2015

TORMJ

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Heat and moisture exchangers (HMEs) and heated humidifiers (HHs) in adult critically ill patients: a systematic review, meta-analysis and meta-regression of randomized controlled trials

et al. 2017

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BackgroundThe aims of this systematic review and meta-analysis of randomized controlled trials are to evaluate the effects of active heated humidifiers (HHs) and moisture exchangers (HMEs) in preventing artificial airway occlusion and pneumonia, and on mortality in adult critically ill patients. In addition, we planned to perform a meta-regression analysis to evaluate the relationship between the incidence of artificial airway occlusion, pneumonia and mortality and clinical features of adult critically ill patients.MethodsComputerized databases were searched for randomized controlled trials (RCTs) comparing HHs and HMEs and reporting artificial airway occlusion, pneumonia and mortality as predefined outcomes. Relative risk (RR), 95% confidence interval for each outcome and I 2 were estimated for each outcome. Furthermore, weighted random-effect meta-regression analysis was performed to test the relationship between the effect size on each considered outcome and covariates.ResultsEighteen RCTs and 2442 adult critically ill patients were included in the analysis. The incidence of artificial airway occlusion (RR = 1.853; 95% CI 0.792–4.338), pneumonia (RR = 932; 95% CI 0.730–1.190) and mortality (RR = 1.023; 95% CI 0.878–1.192) were not different in patients treated with HMEs and HHs. However, in the subgroup analyses the incidence of airway occlusion was higher in HMEs compared with HHs with non-heated wire (RR = 3.776; 95% CI 1.560–9.143). According to the meta-regression, the effect size in the treatment group on artificial airway occlusion was influenced by the percentage of patients with pneumonia (β = -0.058; p = 0.027; favors HMEs in studies with high prevalence of pneumonia), and a trend was observed for an effect of the duration of mechanical ventilation (MV) (β = -0.108; p = 0.054; favors HMEs in studies with longer MV time).ConclusionsIn this meta-analysis we found no superiority of HMEs and HHs, in terms of artificial airway occlusion, pneumonia and mortality. A trend favoring HMEs was observed in studies including a high percentage of patients with pneumonia diagnosis at admission and those with prolonged MV. However, the choice of humidifiers should be made according to the clinical context, trying to avoid possible complications and reaching the appropriate performance at lower costs.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-017-1710-5) contains supplementary material, which is available to authorized users.

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Review of Artificial Airway Management in Critically Ill Patients

米¹

2021

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Encuesta sobre humidificación de la vía aérea en unidades de cuidados intensivos de adultos de Chile

Abstract: (Rev Med Chile 2012; 140: 1425-1430.

Cited by 3 publications

References 16 publications

Humidification on Ventilated Patients: Heated Humidifications or Heat and Moisture Exchangers?

Humidification on Ventilated Patients: Heated Humidifications or Heat and Moisture Exchangers?

Heat and moisture exchangers (HMEs) and heated humidifiers (HHs) in adult critically ill patients: a systematic review, meta-analysis and meta-regression of randomized controlled trials

Review of Artificial Airway Management in Critically Ill Patients

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