Effect of heated humidified ventilation on bronchial mucus transport velocity in general anaesthesia: A randomized trial

Seo, Hyungseok; Kim, Sung Hoon; Choi, Jeong Hee; Hong, Jeong-Yeon; Hwang, Jai‐Hyun

doi:10.1177/0300060514548291

Cited by 8 publications

(5 citation statements)

References 33 publications

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“…A reasonable explanation for these results is that chest-wall resonance may be transmitted wider than its origin (ie, area of retained secretions), and tactile feedback may transcend the boundaries of the assessed lung zones. Therefore, as stated in previous studies, 6,21 palpable chest-wall fremitus should be always accompanied by other signs of retained secretions to increase the robustness of clinical decisions.…”

Section: Discussionmentioning

confidence: 80%

“…1 Respiratory complications frequently occur in patients who are mechanically ventilated due to the presence of artificial airways 2,3 and sedation, 4 inadequate airway humidification, 5,6 impaired mucociliary clearance, 7 diminished cough, 8 and variable airway pressures. 9 All these factors have the potential to cause respiratory impairment 8,10 and exacerbate pre-morbid respiratory injury or disease.…”

Section: Introductionmentioning

confidence: 99%

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Inter-Rater Agreement of Auscultation, Palpable Fremitus, and Ventilator Waveform Sawtooth Patterns Between Clinicians

2016

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BACKGROUND: Clinicians often use numerous bedside assessments for secretion retention in participants who are receiving invasive mechanical ventilation. This study aimed to evaluate interrater agreement between clinicians when using standard clinical assessments of secretion retention and whether differences in clinician experience influenced inter-rater agreement. METHODS: Seventy-one mechanically ventilated participants were assessed by a research clinician and by one of 13 ICU clinicians. Each clinician conducted a standardized assessment of lung auscultation, palpation for chest-wall (rhonchal) fremitus, and ventilator inspiratory/expiratory flow-time waveforms for the sawtooth pattern. RESULTS: On the presence of breath sounds, agreement ranged from absolute to moderate in the upper zones and the lower zones, respectively. Kappa values for abnormal and adventitious lung sounds achieved moderate agreement in the upper zones, less than chance agreement to substantial agreement in the middle zones, and moderate agreement to almost perfect agreement in the lower zones. Moderate to almost perfect agreement was established for palpable fremitus in the upper zones, moderate to substantial agreement in the middle zones, and less than chance to moderate agreement in the lower zones. Inter-rater agreement on the presence of expiratory sawtooth pattern identification showed moderate agreement. The level of percentage agreement between the research and ICU clinicians for each respiratory assessment studied did not relate directly to level of clinical experience. CONCLUSIONS: Inter-rater agreement for all assessments showed variability between lung regions but maintained reasonable percentage agreement in mechanically ventilated participants. The level of percentage agreement achieved between clinicians did not directly relate to clinical experience for all respiratory assessments. Therefore, these respiratory assessments should not necessarily be viewed in isolation but interpreted within the context of a full clinical assessment.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Inter-Rater Agreement of Auscultation, Palpable Fremitus, and Ventilator Waveform Sawtooth Patterns Between Clinicians

2016

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“…In humans, HHBCs may protect the tracheobronchial ciliated epithelium from damage caused by dry gasses and can help maintain mucociliary clearance during general anesthesia. 26,27 Additional research is needed to investigate these effects in animals.…”

Section: Discussionmentioning

confidence: 99%

The effect of adding a heated humidified breathing circuit on body temperature in healthy anesthetized dogs

Jones

Burns

Reed

et al. 2023

javma

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OBJECTIVE To compare the effect of a circulating warm water blanket (WWB) in combination with a heated humidified breathing circuit (HHBC) heated to 45 °C on rectal temperature (RT) in dogs undergoing general anesthesia for elective ovariohysterectomies. ANIMALS 29 healthy dogs. PROCEDURES Dogs in the experimental group (n = 8) and dogs in the control group (21) were connected to an HHBC and a conventional rebreathing circuit, respectively. All dogs were placed on a WWB in the operating room (OR). The RT was recorded at baseline, premedication, induction, transfer to OR, every 15 minutes during maintenance of anesthesia, and extubation. Incidence of hypothermia (RT < 37 °C) at extubation was recorded. Data were analyzed using unpaired t tests, the Fisher exact test, and mixed-effect ANOVA. Statistical significance was defined as P < .05. RESULTS There was no difference in RT during baseline, premedication, induction, and transfer to OR. The overall RT was higher for the HHBC group during anesthesia (P = .005) and at extubation (37.7 ± 0.6 °C) compared with the control group (36.6 ± 1.0 °C; P = .006). The incidence of hypothermia at extubation was 12.5% for the HHBC group and 66.7% for the control group (P = .014). CLINICAL RELEVANCE The combination of HHBC and WWB can reduce the incidence of postanesthetic hypothermia in dogs. Use of an HHBC should be considered in veterinary patients.

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“…Because normothermic thoraco-abdominal aortic aneurysm repair surgery requires one-side lung ventilation to ensure the surgical field of vision, this is both a cause of lung infection and affects the effectiveness of HHV. HHV effectively maintains mucociliary clearance of patients during the general anesthesia, and it may reduce the risk of pulmonary infection to some extend (16). Hypothermia itself may delay healing and predispose patients to wound infections.…”

Section: Discussionmentioning

confidence: 99%

Effect of heated humidified ventilation on intraoperative core temperature and prognosis in normothermic thoraco-abdominal aortic aneurysm repair

Zhao

Jiang

et al. 2020

J Thorac Dis

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Background: To evaluate whether the heated humidified ventilation can effectively maintain core temperature and improve prognosis in normothermic thoraco-abdominal aortic aneurysm repair surgery. Methods: Patients who were scheduled for normothermic thoraco-abdominal aortic aneurysm repair surgery were randomized into the group using heated humidified ventilation combined with water blanket and the group using water blanket only. During the operation, the core temperature will be measured every 30 minutes. We analyzed intraoperative core-temperature, coagulation function and in-hospital mortality. Results: HHV&WB group showed lesser decrease in core temperature than WB groups in the first two hours, while WB group had a higher body temperature at the third to fifth hour (2-hour: 35.45±0.47 vs. 35.24±0.59 ℃, P=0.284; 5-hour: 35.38±0.70 vs. 35.51±0.88 ℃, P=0.664). There was less blood loss, dosage of coagulation drugs and in-hospital mortality (13.33% vs. 20.00%, P=1) in the HHV&WB group.Conclusions: Heated humidified ventilation can improve the prognosis of normothermic thoracoabdominal aortic aneurysm repair surgery to some extent, but it can only maintain the core temperature during the first 2 hours.

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Effect of heated humidified ventilation on bronchial mucus transport velocity in general anaesthesia: A randomized trial

Abstract: Heated humidified ventilation effectively maintains mucociliary clearance of patients during sevoflurane general anaesthesia.

Cited by 8 publications

References 33 publications

Inter-Rater Agreement of Auscultation, Palpable Fremitus, and Ventilator Waveform Sawtooth Patterns Between Clinicians

Inter-Rater Agreement of Auscultation, Palpable Fremitus, and Ventilator Waveform Sawtooth Patterns Between Clinicians

The effect of adding a heated humidified breathing circuit on body temperature in healthy anesthetized dogs

Effect of heated humidified ventilation on intraoperative core temperature and prognosis in normothermic thoraco-abdominal aortic aneurysm repair

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