Humidification Performance of Passive and Active Humidification Devices Within a Spontaneously Breathing Tracheostomized Cohort.

BACKGROUND: Most heat-and-moisture exchangers (HMEs) for patients with tracheostomy and spontaneously breathing are small and have suction ports that allow some expiratory gas to escape, which loses vapor held in the expired gas. Recently, a heated-and-humidified high-flow system for spontaneously b...

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Publicado en:Respiratory Care Vol. 64; no. 2; pp. 130 - 136
Autores principales: Nobuto Nakanishi, Jun Oto, Taiga Itagaki, Emiko Nakataki, Mutsuo Onodera, Masaji Nishimura
Formato: CEU pictorial research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Feb2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2019
      vid: 64
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        10.4187/respcare.06294
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        atl: Humidification Performance of Passive and Active Humidification Devices Within a Spontaneously Breathing Tracheostomized Cohort.
      aug:
        au:
          Nobuto Nakanishi
          Jun Oto
          Taiga Itagaki
          Emiko Nakataki
          Mutsuo Onodera
          Masaji Nishimura
        affil: Emergency and Critical Care Medicine, Tokushima University Hospital, Tokushima, Japan
      sug:
        subj:
          Tracheostomy
          Humidity Equipment and Supplies
          Respiration, Artificial Methods
          Humidity Evaluation
          Human
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Japan
          Education, Continuing (Credit)
          Crossover Design
          Comparative Studies
          Descriptive Statistics
          One-Way Analysis of Variance
          Data Analysis Software
          Friedman Test
          Post Hoc Analysis
          Two-Tailed Test
          Oxygenation
          Temperature
          Capnography
          Respiratory Failure
          Heart Arrest
          Intubation, Intratracheal
          Tidal Volume
          APACHE (Acute Physiology and Chronic Health Evaluation)
          Clinical Assessment Tools
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: BACKGROUND: Most heat-and-moisture exchangers (HMEs) for patients with tracheostomy and spontaneously breathing are small and have suction ports that allow some expiratory gas to escape, which loses vapor held in the expired gas. Recently, a heated-and-humidified high-flow system for spontaneously breathing patients with tracheostomy was developed. Little is known, however, about the humidifying performance of HMEs or heated-and-humidified high-flow systems for spontaneous breathing patients with a tracheostomy. OBJECTIVE: To investigate the humidifying performance of the HMEs and heated-and-humidified high-flow systems for spontaneously breathing patients with tracheostomy. METHODS: Adult spontaneously breathing subjects with tracheostomy and were enrolled when their respiratory parameters and ... were stable. We measured absolute humidity, relative humidity, and temperature by using a capacitance-type moisture sensor at the outlet of the tracheostomy tube. Heated-and-humidified high flow was delivered via the a humidifier and tracheostomy interface, and a selected HME. The subjects received heated-and-humidified high flow, after which an HME was used for humidification before switching back to a heated-and-humidified high-flow system. RESULTS: Ten subjects (5 men, 5 women; mean ± SD age, 72 ± 12 y) were enrolled. The admission diagnoses were neurologic (5 subjects), respiratory failure (3), and cardiac arrest (2). The APACHE (Acute Physiology and Chronic Health Evaluation) II score was 24 (interquartile range, 20-27). Tracheostomy was performed on day 7 (interquartile range, 5-11 d) after endotracheal intubation, and the duration of mechanical ventilation was 10 d (interquartile range, 6-11 d). The temperature with the HME was 29.9 ± 1.0°C and, during heated-and-humidified high-flow use was 35.3 ± 0.8°C (P < .001). With both the HME and the heated-and-humidified high-flow system, the relative humidity reached 100%; the absolute humidity with HME was 30.2 ± 1.8 mg/L, and, with the heated-and-humidified high-flow system, was 40.3 ± 1.8 mg/L (P < .001). CONCLUSIONS: In spontaneously breathing subjects with tracheostomy, an heated-and-humidified high-flow system achieved higher absolute humidity than did an HME.
      pubtype: Academic Journal
      doctype:
        CEU
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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