[Design and application of a multifunctional continuous humidification device in tracheostomy patients]

Tracheostomy is an important therapeutic measure to relieve airway obstruction and ensure effective ventilation in patients. However, the procedure bypasses the natural upper airway, compromising its normal defensive functions, which can lead to drying of secretions, crust formation, potential tube occlusion, and ultimately pulmonary infection. Adequate airway humidification can help dilute sputum, facilitate sputum drainage, and ultimately reduce the incidence of airway-related complications. Although several airway humidification methods have been reported, their outcomes remain unsatisfactory. To address this, the intensive care unit staff of Hangzhou First People's Hospital, designed a multifunctional continuous humidification device consisting of a cover, connecting tube, and nebulizer for airway humidification, which has been granted a national utility model patent of China (patent number: ZL 2021 2 0079525.4). A total of 48 patients requiring oxygen therapy via a tracheostomy at the intensive care unit of Hangzhou First People's Hospital between August 2023 and June 2024 were selected as the study subjects. Using a random number table, they were assigned in a 1 : 1 ratio to an experimental group (n=24) and a control group (n=24). From the initiation of the transition from mechanical ventilation weaning to continuous oxygen inhalation via the tracheostomy, the experimental group received humidification using the multifunctional continuous humidification device, while the control group received humidification using a traditional humidifier. The daily humidification protocol was consistent for both groups and was implemented by nursing staff who had undergone homogenized training. General patient data, the incidence of complications during humidified oxygen therapy via tracheostomy, nursing staff satisfaction, and sputum viscosity grading on day 1, 7, and 14 of airway humidification were compared between the two groups. The results showed no statistically significant differences in gender, age, disease types, or pre-humidification sputum viscosity grades between the two groups. The incidence of complications in the experimental group was lower than that in the control group during the treatment [crust formation: 4% (1/24) vs. 54% (13/24); airway mucosal injury: 8% (2/24) vs. 42% (10/24); pulmonary infection: 4% (1/24) vs. 54% (13/24)]. Nursing staff satisfaction was also found to be significantly higher in the experimental group [100% (24/24) vs. 17% (4/24)]. All these differences were statistically significant (all P<0.05). The sputum viscosity grades on day 1, 7, and 14 were also significantly more favorable in the experimental group than in the control group (all P<0.05). These findings indicate that the application of this device in tracheostomy patients effectively maintained airway humidification, ensured respiratory tract patency, improved airway clearance efficacy, reduced the frequency of sputum suction, and prevented airway complications, and enhances nursing efficiency, demonstrating good potential for clinical promotion.