Airway humidification with a heat and moisture exchanger in mechanically ventilated neonates : a preliminary evaluation

Intensive Care Med. 2007 Feb;33(2):336-43. doi: 10.1007/s00134-006-0466-1. Epub 2006 Dec 13.

Abstract

Objective: We set out to evaluate the efficacy of passive inspiratory gas conditioning in mechanically ventilated neonates and compared it with that of a heated humidifier (HH).

Design: Prospective, randomized, controlled study.

Setting: Neonatal and pediatric intensive care unit.

Patients: Fourteen mechanically ventilated neonates nursed in incubators.

Interventions: The HH was set to deliver a temperature of 37 degrees C and an absolute humidity of 40 mgH(2)O/l at the incubator entrance. Inspired temperature (T degrees ) and absolute humidity (AH) were measured by the psychometric method, transpulmonary pressure (Tpres) by means of a differential pressure transducer. Measurements were performed at 5, 10, and 15 min.

Measurements and results: The values of T degrees were significantly higher using the HH (34.6+/-1.6 degrees C) than the heat and moisture exchanger (HME) (33.8+/2.3, p<0.001). The values of AH were significantly higher using the HH (36.6+/-2.5 mgH(2)O/l) than the HME (32.4+/-2.8 mgH(2)O/l, p<0.001). No significant changes were observed in transpulmonary pressure. A significant positive correlation was observed between incubator temperature and the temperature delivered by the HH (R(2)=0.61, p<0.001).

Conclusions: The use of HMEs in neonates made it possible to achieve an absolute humidity of 28 mgH(2)O/l or more and a temperature of 30 degrees C or more. Higher values are obtained using a HH.

Publication types

  • Evaluation Study
  • Randomized Controlled Trial

MeSH terms

  • Hot Temperature
  • Humans
  • Humidity
  • Incubators, Infant
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Respiration, Artificial / instrumentation*
  • Respiratory Distress Syndrome, Newborn / therapy*