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Effect of Heat and Moisture Exchanger vs Heated Humidifier on Ventilator-related Adverse Events in Children: A Pilot
Sivamurukan Palanisamy1, Sreedeep Kodakkattil Sreevilasan1, Lolam Venkatesh1
1Pediatric Intensive Care Unit, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Background And Aims:
Heating and humidification of ventilator gas are essential to ensure optimal ventilator support in critically ill children. Heat and moisture exchangers (HME) offer a simpler and more cost-effective method of humidification compared to active systems like heated humidifiers (HH). However, the efficacy and impact of HME on ventilator-related adverse events (VAEs) in children remain underexplored. This study aims to compare the incidence of VAEs in children managed with HME versus those using a HH during mechanical ventilation.
Patients And Methods:
This open-label randomized controlled trial was conducted in the pediatric intensive care unit (PICU) of a tertiary care hospital in South India from January 2022 to July 2023. Sixty children aged 2-15 years, who were expected to require mechanical ventilation for more than 48 hours, were enrolled. Patients were randomized into two groups after age-based stratification (2-5 years and 6-15 years). The intervention group received humidification via HME, while the control group received a HH. Patients were monitored until discharge, and daily assessments were performed to identify any VAEs for the first 7 days of mechanical ventilation.
Results:
The primary outcome was the incidence of VAEs, expressed per 1,000 ventilator days. The HME group reported 28.36 VAEs per 1,000 ventilator days, while the HH group had 12.98 VAEs per 1,000 ventilator days. This difference was not statistically significant (p = 0.42). Other variables, including the average frequency of suctioning per day, total ventilator days, maximal peak inspiratory pressure, and mortality, were comparable between the groups.
Conclusion:
This pilot randomized controlled trial did not find a statistically significant difference in the incidence of VAEs between use of HME and HHs in children. Given its simplicity and cost-effectiveness, HME may be cautiously considered for use in mechanically ventilated pediatric patients aged 2-15 years.
How To Cite This Article:
Palanisamy S, Kodakkattil Sreevilasan S, Venkatesh L, Jose D, Gowtham BC, Parameswaran N. Effect of Heat and Moisture Exchanger vs Heated Humidifier on Ventilator-related Adverse Events in Children: A Pilot Randomized Controlled Trial. Indian J Crit Care Med 2025;29(9):746-752.
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