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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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ORIGINAL ARTICLES  CRITICAL AND INTENSIVE THERAPY


Minerva Anestesiologica 1998 March;64(3):75-81

language: English

Com­par­ison of ­three dif­ferent humid­ifi­ca­tion ­systems during pro­longed mechan­ical ven­ti­la­tion

Luchetti M. 1, Stuani A. 2, Castelli G. 2, Marrano G. 1

1 Azienda Osped­a­liera «Fateb­e­nef­ra­telli e Oftal­mico» - ­Milano, Ser­vizio di Anes­tesia e Rian­i­maz­ione;
2 Azienda Osped­a­liera «­Carlo ­Poma» - Man­tova, Ser­vizio di Anes­tesia e Rian­i­maz­ione


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Back­ground. An effi­cient humid­ifi­ca­tion ­system is ­expected to main­tain ­fluid and ­easily drain­able ­airway secre­tions. ­This ­study ­aims to com­pare the effi­ciency and ­safety of ­three humid­ifi­ca­tion ­systems ­during pro­longed mechan­ical ven­ti­la­tion.
­Design. Two-­center, pros­pec­tive, ran­dom­ized ­study.
­Methods. 45 crit­i­cally ill ­patients under­going mechan­ical ven­ti­la­tion ­were ­included in the ­study and allo­cated to ­receive one of ­three humid­ifi­ca­tion tech­niques: 1) Ben­nett Cas­cade ­water-­bath humid­i­fier (Ben­nett ­group); 2) ­Fisher & ­Paykel ser­vo­con­trolled humid­i­fier (F & P ­group); 3) HME ­Hygrobac DAR (HME ­group). Clin­ical and experi­mental obser­va­tions ­were con­ducted for 3 to 7 con­sec­u­tive ­days and ­included: ­body T°, ­room T°, ­inspired gas T°, tra­cheal T°, rel­a­tive and abso­lute ­humidity, ­heat and ­water ­loss, ­airway secre­tion ­score, ­need for endo­tra­cheal ­saline instil­la­tion and inci­dence of ETT occlu­sion.
­Results. The HME ­group ­showed a ­lower tem­per­a­ture of ­inspired ­gases com­pared to the F & P ­group (p<0.05); it ­also ­showed a ­lower abso­lute ­humidity com­pared to ­both Ben­nett and F & P ­groups (p<0.05). A ­better ­airway secre­tion ­score was ­obtained in Ben­nett and F & P ­groups com­pared to the HME ­group (p<0.01).
Con­clu­sions. Pas­sive humid­ifi­ca­tion ­systems pro­vided low ­degrees of ­humidity and tem­per­a­ture and ­could not main­tain ­good secre­tions. ­Active ­systems ­appeared to sat­isfy the rec­om­mended stan­dards and to ­allow ­fluid and ­easily drain­able secre­tions.

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