Knowledge and Practice of Mechanical Ventilation Humidification Systems in Latin American ICUs

Background: Humidification of inspired gases is critical for maintaining airway integrity in mechanically ventilated patients. However, airway instrumentation and the use of cold, dry medical gases can disrupt this process, necessitating external humidification systems. This study aimed to assess knowledge and practices regarding humidification systems in mechanical ventilation among health care professionals in Latin American ICUs. Methods: A cross-sectional, digital survey was conducted from April to August 2024, targeting ICU professionals across Latin America. The questionnaire assessed operational and clinical knowledge of heat-and-moisture exchangers (HMEs) and heated humidifiers, as well as their use in mechanical ventilation. Participants were recruited through professional societies and personal networks. Data were analyzed using descriptive and inferential statistics, with significance set at P < .05. Results: A total of 510 valid responses were analyzed, representing 20 countries. Most respondents were respiratory therapists (73%) with over 5 years of ICU experience (43%). HMEs were the first-line option for mechanical ventilation in 68% of cases, whereas 69% used humidification systems in noninvasive ventilation, favoring heated humidifiers. The median correct response rate showed significant differences by profession (P < .001) and education level (P < .001). Only 31% of respondents correctly identified the recommended minimum absolute humidity, and only 5.3% reported routine maintenance of heated systems. Conclusions: This study highlights critical gaps in knowledge and practices related to humidification systems in ICUs. The observed differences in performance based on profession and level of training suggest that continuing education and specialization are essential to optimize clinical practice.