Safety, efficacy, and cost-effectiveness of mechanical ventilation with humidifying filters changed every 48 hours: A prospective, randomized study

Abstract

Some HMEs may be used safely for 48 hrs without change. However, this does not pertain to every brand of HME. Objective in vivo evaluation of their humidifying performances is decisive before extending their duration of use.

Changing patterns of airway accidents in intubated ICU patients

“…We postulate that it may have some relation to a change in the humidification protocol. At the end of 1996, in an attempt at decreasing costs, we started using HMEFs for 48 h instead of the previous more conventional 24 h. This practice of using HMEFs for 48 h has been found to be safe [15,16,17,18] and recent evidence suggest that the use for 96 h too may be safe [19]. The authors of the above studies, however, conceded the need for larger studies.…”

Risk Factors for Ventilator‐Associated Pneumonia: From Epidemiology to Patient Management

“…A large number of prospective, randomized trials have shown that the frequency of ventilator circuit change does not affect the incidence of VAP [76,77]. Use of passive humidifiers with or without filtering capacity has been shown to decrease circuit colonization by bacteria, but it has not been shown to reduce the incidence of VAP, and, with regard to infection control, there is no benefit to changing passive humidifiers any more frequently than every 48 h [78][79][80][81][82].…”

Heat and moisture exchangers in mechanically ventilated intensive care unit patients: A plea for an independent assessment of their performance

“…Extending the use of HMEs in this population would undoubtedly reduce cost of mechanical ventilation. Several studies have indeed shown that changing HMEs only every other day was safe and cost-effective in COPD patients (22,23). Our initial goal was to further evaluate prolonged use of HMEs in COPD patients by using a supposedly more efficient HME.…”

“…Particular attention was given to place the HME vertically above the tracheal tube to reduce the risk of partial obstruction of the HME due to refluxed secretions from the tracheal tube (22,23). Nurses and doctors repeatedly checked the position of the HME.…”

“…The variables recorded daily to assess HMEs have already been used in our previous studies (7,20,22,23). These include the number of tracheal suctionings (which are usually performed every 4 hrs and whenever breathing sounds are heard) and peak airway pressures that were recorded every 4 hrs and averaged over 24 hrs (they are subsequently referred to as mean peak airway pressure).…”