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Airway humidification with a heat and moisture exchanger in mechanically ventilated neonates : a preliminary
Mikaïla Fassassi1, Fabrice Michel, Laurent Thomachot
1Neonatal and Pediatric Intensive Care, Department of Anesthesia and Intensive Care, Hôpital Nord, Boulevard Pierre Dramard, 13915, Marseille Cedex 20, France.
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.
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