The combination of a heat and moisture exchanger and a Booster TM: a clinical and bacteriological evaluation over 96 h

Thomachot, Laurent; Viviand, X.; Boyadjiev, I.; Vialet, Renaud; Martin, Claude

doi:10.1007/s00134-001-1193-2

Cited by 22 publications

(16 citation statements)

References 28 publications

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“…Esses resultados 12 , que, em análise bacteriológica de 33 FTCU Hygrobac DAR, após 7 dias de uso, encontraram 20 FTCU esté-reis, entre os quais em 13 havia crescimento bacteriano insignificante. Thomachot et al 22 afirmam que o FTCU é impregnado com substâncias químicas que são meios pobres para o crescimento bacteriano.…”

Section: Discussionunclassified

“…No grupo estudado, realizou-se troca do FTCU a cada 24 horas, como recomendado pelos fabricantes. No entanto, vários estudos questionam a frequência da troca e seu uso prolongado por mais que 24 horas 22,23,25 . Djedaini et al 29 mostraram que as propriedades de filtro bacteriológico de um FTCU não foram modificadas com o uso por 48 horas e que a incidência de PAV foi idêntica entre indivíduos que usaram por 24 ou 48 horas.…”

Section: Discussionunclassified

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Trocador de calor e umidade: proteção contra infecções pulmonares? Estudo piloto

Alcoforado¹,

Paiva²,

Silva³

et al. 2012

Fisioter. Pesqui.

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| The aim of this study was to conduct a bacteriological research comparing the aqueous heated humidification systems (HH) and filter heat and moisture exchanger (FHME) and to bacterial colonization and the incidence of respiratory infection in patients undergoing mechanical ventilation. It is a prospective, controlled trial, in that 15 intensive care unit (ICU) patients were divided into two groups. The first made use of HH (n=7) and the other, FHME (n=8). We collected samples of tracheal secretions, and condensate circuit FHME at admission in the fourth and eighth day and bacteriological analysis of the same place. Regarding the anthropometric characteristics, no differences were observed between the groups. The prevalence of ventilator associated pneumonia (VAP) was 57.1% in the HH and 62.5% in FHME. When performing quantitative bacteriological analysis between the group and HH and FHME, differences were not observed, suggesting no variation in the prevention of VAP between the humidification systems, but the presence of these bacteria in the tracheal and condensate and in the absence of these membrane FHME may indicate that the main source of contamination is the patient himself.Keywords | respiration, artificial; humidity; ventilators, mechanical; pneumonia, ventilator-associated; respiratory protective devices.RESUMO | O objetivo deste trabalho foi realizar um estudo bacteriológico comparativo entre os sistemas de umidificação aquoso aquecido (UAA) e filtro trocador de calor e umidade (FTCU) quanto à colonização bacteriana e a incidência de infecção respiratória em pacientes submetidos à ventilação mecânica (VM). Trata-se de uma pesquisa prospectiva, controlada e randomizada, na qual 15 pacientes internados na Unidade de Terapia Intensiva (UTI) foram distribuídos em dois grupos. O primeiro fez uso de UAA (n=7) e o outro de FTCU (n=8). Foram coletadas amostras da secreção traqueal, condensado do circuito e FTCU na admissão do paciente, no quarto e oitavo dias, e realizada análise bacteriológica dos mesmos. Quanto às características antropométricas, não observou-se diferenças entre os grupos estudados. A prevalência de pneumonia associada à ventilação (PAV) foi de 57,1% no UAA e 62,5% no FTCU. Ao realizar a análise bacteriológica quantitativa entre eles, não foram observadas variações, sugerindo não haver diferença na prevenção de PAV entre os sistemas de umidificação; porém a presença das mesmas bactérias na secreção traqueal e no condensado e ausência destas na membrana do FTCU podem indicar que a principal fonte de contaminação é o próprio paciente.Descritores | respiração artificial; umidade; ventiladores mecânicos; pneumonia associada à ventilação mecânica; dispositivos de proteção respiratória.

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Section: Discussionunclassified

Trocador de calor e umidade: proteção contra infecções pulmonares? Estudo piloto

Alcoforado¹,

Paiva²,

Silva³

et al. 2012

Fisioter. Pesqui.

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“…12 Other active HMEs were tested and provided data in line with our results, with better hygrometric performance in comparison with the last generation of HMEs and with the possibility of maintaining adequate humidity when the active function is turned on or off. 25,26 It may be justified to seek systems that improve humidification performance with stable levels Ͼ 35 mg H 2 O/L. Indeed, there are very seldom endotracheal tube occlusions when humidification devices deliver inspiratory water content of ϳ30 mg H 2 O/L.…”

Section: Discussionmentioning

confidence: 99%

Influence of Ambient Temperature and Minute Ventilation on Passive and Active Heat and Moisture Exchangers

et al. 2013

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OBJECTIVE: During invasive mechanical ventilation, inspired gases must be humidified. We previously showed that high ambient temperature greatly impaired the hygrometric performance of heated wire-heated humidifiers. The aim of this bench and clinical study was to assess the humidification performance of passive and active heat and moisture exchangers (HMEs) and the impact of ambient temperature and ventilator settings. METHODS: We first tested on the bench a device with passive and active humidification properties (Humid-Heat, Teleflex), and 2 passive hydrophobic/hygroscopic HMEs (Hygrobac and Hygrobac S, Tyco Healthcare). The devices were tested at 3 different ambient temperatures (from 22 to 30°C), and at 2 minute ventilation settings (10 and 20 L/min). Inspired gas hygrometry was measured at the Y-piece with the psychrometric method. In addition to the bench study, we measured the hygrometry of inspired gases in 2 different clinical studies. In 15 mechanically ventilated patients, we evaluated Humid-Heat at different settings. Additionally, we evaluated Humid-Heat and compared it with Hygrobac in a crossover study in 10 patients. RESULTS: On the bench, with the Hygrobac and Hygrobac S the inspired absolute humidity was ϳ30 mg H 2 O/L, and with the Humid-Heat, slightly < 35 mg H 2 O/L. Ambient temperature and minute ventilation did not have a clinically important difference on the performance of the tested devices. During the clinical evaluation, Humid-Heat provided inspired humidity in a range from 28.5 to 42.0 mg H 2 O/L, depending on settings, and was only weakly influenced by the patient's body temperature. CONCLUSIONS: In this study both passive and active HMEs had stable humidification performance with negligible influence of ambient temperature and minute ventilation. This contrasts with previous findings with heated wire-heated humidifiers. Although there are no clear data demonstrating that higher humidification impacts outcomes, it is worth noting that humidity was significantly higher with the active HME.

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“…Capacitance hygrometers are commercially available, but the results provided may be difficult to interpret. 12 Indeed, variations between the minimum and maximum values of absolute humidity during inspiration with these hygrometers attain 10 mg H 2 O/L, limiting the interpretation of the results. 12 The differences between the tested HMEs' performances and the manufacturer's data also raise questions, as previous studies showed large differences in the opposite direction.…”

Section: See the Original Studies On Pages 1442 And 1449mentioning

confidence: 90%

“…12 Indeed, variations between the minimum and maximum values of absolute humidity during inspiration with these hygrometers attain 10 mg H 2 O/L, limiting the interpretation of the results. 12 The differences between the tested HMEs' performances and the manufacturer's data also raise questions, as previous studies showed large differences in the opposite direction. 9,10 Such reported high humidification performances of the tested HME with a very low internal volume (mean internal volume of 15 mL) seem difficult to attain.…”

Section: See the Original Studies On Pages 1442 And 1449mentioning

confidence: 90%

Assessment of Humidification Performance: Still No Easy Method!

Cuquemelle

Lellouche

2013

Respir Care

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The combination of a heat and moisture exchanger and a Booster TM: a clinical and bacteriological evaluation over 96 h

Abstract: Adding the Booster to a hydrophobic HME improved the heat and water preservation of ventilatory gas.

Cited by 22 publications

References 28 publications

Trocador de calor e umidade: proteção contra infecções pulmonares? Estudo piloto

Trocador de calor e umidade: proteção contra infecções pulmonares? Estudo piloto

Influence of Ambient Temperature and Minute Ventilation on Passive and Active Heat and Moisture Exchangers

Assessment of Humidification Performance: Still No Easy Method!

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