Vergleich verschiedener Atemgas-Anfeuchtersysteme für die Respiratortherapie Frühgeborener im Inkubator

Summary. The warming and humidification of inspired gases for ventilated neonates are routine. There are no data on the temperature of the gas at the airway opening in ventilated neonates. Is the inspired gas temperature at the airway opening, as expected and set on the humidifier, around 378C? We aimed to measure temperature at the airway opening and compare this with the circuit temperature. This was an observational study in a neonatal intensive care unit. Twenty-five mechanically ventilated infants were studied. All had humidifiers with chamber temperature set at 368C and the circuit temperature set at 378C. Two temperature probes were inserted and rested at the circuit-exit and at the airway opening, and temperatures were measured for 2 min in each infant. At this time, the circuit temperature was also noted. The mean (SD) temperature at the airway opening in infants nursed in incubators was 34.9 (1.2)8C, compared with radiant warmers where the mean (SD) was 33.1 (0.5)8C. The mean (SD) difference in temperature from the circuit temperature probe to the airway opening was greater under radiant warmers, with a mean (SD) drop of 3.9 (0.6)8C compared with a mean (SD) drop of 2.0 (1.3)8C in the incubators. In conclusion, the temperature at the circuit temperature probe does not reflect the temperature at the airway opening. Inspired gas temperatures are lower than the expected 378C with the normal circuits and usual humidifier settings.

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Inspired gas temperature in ventilated neonates

Davies

Dunster

Cartwright

2004

Pediatric Pulmonology

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An experimental model for the measurement of inspired gas temperatures in ventilated neonates

Jardine

Dunster

Davies

2007

Pediatric Pulmonology

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Summary. ObjectiveTo determine the inspired gas temperature at points from the endo-tracheal tube (ETT) circuit manifold to the tip of the ETT in a model neonatal lung. Design A model lung attached to standard ventilator circuit, autofeed chamber and humidifier was ventilated using typical pressure-limited, time cycled settings. Temperatures were measured at various distances along the ETT using a K-type thermocouple temperature probe. Results The inspired gas temperature dropped from the circuit temperature probe site (408C) to the proximal end of the ETT (378C). The temperature dropped further as it passed through the exposed part of the ETT (348C) but then warmed again on entering the lung model so that the inspired gas at the distal end of the ETT was 378C. Statistically significant differences were found with a one-way ANOVA P-value of <0.0001. The differences between each pair of mean temperatures were statistically significant (all P < 0.001) except when comparing the proximal end of the ETT with midway down the ETT (Bonferroni's Multiple Comparison Test, P > 0.05). Conclusions Inspired gas temperature drops as it passes through the circuit temperature probe site, the proximal end of the ETT and the exposed part of the ETT. The inspired gas rewarms on entering the model lung and exits the ETT at the desired temperature. The effect of measuring temperature closer to the patient, setting the circuit temperature higher and/or increasing the ambient temperature through which the circuit passes, need to be evaluated.

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Vergleich verschiedener Atemgas-Anfeuchtersysteme für die Respiratortherapie Frühgeborener im Inkubator

Abstract: No controlled clinical tests regarding the importance and long term effects of different levels in the inspiratory air are so far available for the ventilatory treatment of neonates.

Cited by 2 publications

References 8 publications

Inspired gas temperature in ventilated neonates

Inspired gas temperature in ventilated neonates

An experimental model for the measurement of inspired gas temperatures in ventilated neonates

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