Humidification Performance of 48 Passive Airway Humidifiers

Lellouche, François; Taillé, Solenne; Lefrançois, Frédéric; Deye, Nicolas; Maggiore, Salvatore Maurizio; Jouvet, Philippe; Ricard, Jean‐Damien; Fumagalli, B; Brochard, Laurent

doi:10.1378/chest.08-0679

Cited by 66 publications

(80 citation statements)

References 45 publications

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“…One-way valves prevented mixing of inspired and expired gases. Our model was similar to that of Lellouche et al 5 The compliance of the lung compartment was set at 0.05 L/cm H 2 O, and the ventilator was set in continuous mandatory ventilation mode with breathing frequencies of 10 and 20 breaths/min; V T of 300, 500, and 700 mL; inspiratory time of 1.0 s; and PEEP of 3 cm H 2 O. A ventilator self-test was performed before the study.…”

Section: Methodssupporting

confidence: 78%

“…5 HMEs for mechanically ventilated patients are configured differently than those for tracheostomized spontaneously breathing patients. All the HMEs we tested have a suction port through which the patient inspires ambient air.…”

Section: Discussionmentioning

confidence: 99%

“…These findings are in line with those in the Lellouche study. 5 One of the great advantages of a bench study is that it enables investigation and comparison of medical devices under the same conditions. Even so, it was not possible to maintain all environmental and simulated spontaneous breathing conditions.…”

Section: Discussionmentioning

confidence: 99%

“…3 Heat and moisture exchangers (HMEs) and heated humidifiers are commonly employed to warm and humidify medical gases, and are widely used with adult patients undergoing mechanical ventilation. 4 Their performance has been thoroughly investigated, and the results suggest that performance depends on brand, 5 location in the ventilator circuit, tidal volume (V T ), and minute volume. 6,7 SEE THE RELATED EDITORIAL ON PAGE 1559 HMEs are also applied to tracheostomized patients who are able to breathe spontaneously.…”

Section: Introductionmentioning

confidence: 99%

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Humidification Performance of Humidifying Devices for Tracheostomized Patients With Spontaneous Breathing: A Bench Study

et al. 2013

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BACKGROUND: Heat and moisture exchangers (HMEs) are commonly used for humidifying respiratory gases administered to mechanically ventilated patients. While they are also applied to tracheostomized patients with spontaneous breathing, their performance in this role has not yet been clarified. We carried out a bench study to investigate the effects of spontaneous breathing parameters and oxygen flow on the humidification performance of 11 HMEs. METHODS: We evaluated the humidification provided by 11 HMEs for tracheostomized patients, and also by a system delivering high-flow CPAP, and an oxygen mask with nebulizer heater. Spontaneous breathing was simulated with a mechanical ventilator, lung model, and servo-controlled heated humidifier at tidal volumes of 300, 500, and 700 mL, and breathing frequencies of 10 and 20 breaths/min. Expired gas was warmed to 37°C. The high-flow CPAP system was set to deliver 15, 30, and 45 L/min. With the 8 HMEs that were equipped with ports to deliver oxygen, and with the high-flow CPAP system, measurements were taken when delivering 0 and 3 L/min of dry oxygen. After stabilization we measured the absolute humidity (AH) of inspired gas with a hygrometer. RESULTS: AH differed among HMEs applied to tracheostomized patients with spontaneous breathing. For all the HMEs, as tidal volume increased, AH decreased. At 20 breaths/min, AH was higher than at 10 breaths/min. For all the HMEs, when oxygen was delivered, AH decreased to below 30 mg/L. With an oxygen mask and high-flow CPAP, at all settings, AH exceeded 30 mg/L. CONCLUSIONS: None of the HMEs provided adequate humidification when supplemental oxygen was added. In the ICU, caution is required when applying HME to tracheostomized patients with spontaneous breathing, especially when supplemental oxygen is required.

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Section: Methodssupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Humidification Performance of Humidifying Devices for Tracheostomized Patients With Spontaneous Breathing: A Bench Study

et al. 2013

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“…Destaca el gran espectro de marcas de HMEF usados el día de la encuesta, la gran mayoría de ellas con una adecuada eficiencia de humidificación reportada (> 30 mgH 2 O/L). Sin embargo, Lellouche et al demostraron diferencias significativas entre la eficiencia de humidificación publicada por los fabricantes y los medidos en laboratorio 22 . Diversos estudios y metaanálisis han relacionado el uso de los diferentes sistemas de humidificación a la incidencia de neumonía asociada a la ventilación mecánica (NAVM).…”

Section: Discussionunclassified