Energy balance in the intubated human airway is an indicator of optimal gas conditioning

Ryan, Stuart; Rankin, Nigel; Meyer, Erwin; Williams, Robert B.

doi:10.1097/00003246-200202000-00015

Cited by 34 publications

(27 citation statements)

References 9 publications

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“…In premature infants, a study from the pre-surfactant, pre-antenatal steroid era found that in infants of <1,500 g ventilated with low-humidity gases of <36.5°C in temperature, respiratory morbidity was greater than in those ventilated with warmer, high-humidity gases [18]. Although the lower airway adds to gas conditioning [6], adult studies suggest that gases for endotracheal ventilation should be conditioned to 37°C and 100% RH to minimise the workload [19]. The ISO (International Organisation for Standardisation) specifies that for all patients with an artificial airway, humidifiers must deliver an absolute humidity of ≥33 mg H 2 O/l [7].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Practical Considerations for Heating and Humidifying Gases during Newborn Stabilisation: An in vitro Model

Owen

Dawson²,

Middleburgh³

et al. 2014

Neonatology

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Background: Gases for respiratory support at birth are typically ‘cold and dry', which may increase the risk of hypothermia and lung injury. Objectives: To determine the feasibility of using heated humidification from birth. Method: A humidifier targeting 37°C, a manual-fill chamber and a Neopuff Infant T-piece resuscitator and circuit were attached to a face mask and a manikin. Recordings using 20 ml H₂O for humidification and a flow of 10 l/min were undertaken. Temperature and relative humidity (RH) were recorded. Additional recordings were made, each with one alteration to baseline (50 ml H₂O for humidification, auto-fill chamber, a flow of 8 l/min, addition of circuit extension piece, warmed humidification H₂O, increased ambient temperature and targeting 31°C). The duration of heated humidification and the response to disconnecting the power were investigated. Results: The baseline circuit achieved 95% RH and 31°C in 3 min, >99% RH in 7 min and ≥35°C in 9 min. No circuit alterations resulted in faster gas conditioning. The extended length circuit and targeting 31°C reduced the maximum temperature achieved. A flow of 8 l/min resulted in slower heating and humidification. The baseline circuit delivered heated humidification for 39 min. Without power, the temperature and humidity fell below international standards in 3 min. Conclusion: Rapid gas conditioning for newborn stabilisation is feasible using the experimental set-up, ≥20 ml H₂O and a flow of 10 l/min. The circuit could be used immediately once switched on. Without power, conditioning is quickly lost. Investigation of the clinical effects of gas conditioning is warranted.

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Section: Discussionmentioning

confidence: 99%

Feasibility and Practical Considerations for Heating and Humidifying Gases during Newborn Stabilisation: An in vitro Model

Owen

Dawson²,

Middleburgh³

et al. 2014

Neonatology

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“…Optiflow (Fisher & Paykel Healthcare, Auckland, New Zealand) is a new nasal high-flow (NHF) oxygen system that allows the delivery of up to 60 L/min of heated and humidified, blended air and oxygen via wide-bore nasal cannula. The system conditions the inspired gas to 37°C and 44 mg H 2 O/L, which is considered thermodynamically neutral to the airway, 3 preserving the function of the ciliated mucosa. 4 Recent work described complications associated with unhumidified high-flow face mask (HFFM) oxygen therapy, which include discomfort and airway drying.…”

Section: Introductionmentioning

confidence: 99%

A Preliminary Randomized Controlled Trial to Assess Effectiveness of Nasal High-Flow Oxygen in Intensive Care Patients

2011

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OBJECTIVE:In a cardiothoracic and vascular intensive care unit, to compare nasal high-flow (NHF) oxygen therapy and standard high-flow face mask (HFFM) oxygen therapy in patients with mild to moderate hypoxemic respiratory failure. METHODS: In a prospective randomized comparative study, 60 patients with mild to moderate hypoxemic respiratory failure were randomized to receive NHF or HFFM. We analyzed the success of allocated therapy, noninvasive ventilation rate, and oxygenation. RESULTS: Significantly more NHF patients succeeded with their allocated therapy (P ‫؍‬ .006). The rate of noninvasive ventilation in the NHF group was 3/29 (10%), compared with 8/27 (30%) in the HFFM group (P ‫؍‬ .10). The NHF patients also had significantly fewer desaturations (P ‫؍‬ .009). CONCLUSIONS: NHF oxygen therapy may be more effective than HFFM in treating mild to moderate hypoxemic respiratory failure.

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“…Rathgeber et al [22] [26,29].Es kann also sowohl zu Unterbefeuchtung als auch zu Überbefeuchtung kommen.…”

Section: Methodenvergleichunclassified

Einfluss von aktiver und passiver Befeuchtung auf die beatmungsassoziierte nosokomiale Pneumonie

et al. 2004

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Energy balance in the intubated human airway is an indicator of optimal gas conditioning

Abstract: Inspired gas at body temperature and saturated is thermodynamically neutral to the intubated airway, and thus may be considered the optimal condition for ventilation lasting more than a few hours.

Cited by 34 publications

References 9 publications

Feasibility and Practical Considerations for Heating and Humidifying Gases during Newborn Stabilisation: An in vitro Model

Feasibility and Practical Considerations for Heating and Humidifying Gases during Newborn Stabilisation: An in vitro Model

A Preliminary Randomized Controlled Trial to Assess Effectiveness of Nasal High-Flow Oxygen in Intensive Care Patients

Einfluss von aktiver und passiver Befeuchtung auf die beatmungsassoziierte nosokomiale Pneumonie

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