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Humidification method that decreases condensate contamination in ventilator tubing
1University of Medicine and Dentistry of New Jersey, Respiratory Care Program, Camden Campus, West Jersey Hospital, Berlin Division, New Jersey, USA.
Objective:
To demonstrate combining unheated bubble-through humidifier with a heat-moisture exchanger filter for the purpose of decreasing condensate contamination in mechanical ventilator tubing.
Design:
Single-case, pretest and posttest.
Setting:
University-affiliated and nonprofit hospital.
Patient:
A 32-year-old man with Pickwickian syndrome and pneumonia caused by Pseudomonas aeruginosa received mechanical ventilation for 14 days.
Methods:
Ventilator tubing was cultured in two 24-hour trials, using a pretest and posttest design, to assess tubing bacterial contamination during use of 2 humidification methods. In the first trial, a traditional heated bubble-through humidifier (HBH) was used for 24 hours. Before the start of the second trial, the "wet" tubing and the heated bubble-through humidifier were removed and replaced with clean equipment through the use of aseptic technique. The bubble-through humidifier was placed on the "cold," or unheated mode, and a heat-moisture exchanger filter was attached to the Y-connector of the ventilator tubing.
Results:
The heated bubble-through humidifier method revealed contamination of the ventilator tubing in 3 places with the patient's strain of P aeruginosa in addition to copious water condensate. The unheated bubble-through humidifier/heat moisture exchanger filter method demonstrated no bacterial contamination or condensate in the tubing.
Conclusion:
It can be inferred that the humidification method using the combination of an unheated bubble-through humidifier and a heat moisture exchanger filter has the potential benefit of preventing "reseeding" of the patient's airway with contaminated condensate.