Heated Humidifiers for Noninvasive Respiratory Support and the Risk of Burns in Neonates: A Bench Evaluation.
BACKGROUND: User errors in managing heated humidifiers (HHs) have been suggested to be a source of nasal burns in newborns treated with nasal CPAP. This study evaluated the risk of burns by reproducing 3 typical errors concerning the use of HHs. METHODS: Six HHs were tested on a bench in a tradition...
| Publicado en: | Respiratory Care Vol. 66; no. 9; pp. 1398 - 1406 |
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| Autores principales: | , , |
| Formato: | CEU pictorial research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Sep2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=152131913&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 152131913 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Sep2021 vid: 66 iid: 9 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 152131913 152131913 152131913 10.4187/respcare.08768 152131913 ppf: 1398 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Heated Humidifiers for Noninvasive Respiratory Support and the Risk of Burns in Neonates: A Bench Evaluation. aug: au: Fau, Sebastien Baud, Olivier Rimensberger, Peter affil: Service of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland sug: subj: Nebulizers and Vaporizers Adverse Effects Heat Adverse Effects Continuous Positive Airway Pressure Burns Risk Factors Risk Assessment Human Error Evaluation Education, Continuing (Credit) Human Infant, Newborn Temperature Evaluation Scales Descriptive Statistics Academic Medical Centers Switzerland Data Analysis Software Patient Safety Algorithms Iatrogenic Disease Infant, Newborn: birth-1 month ab: BACKGROUND: User errors in managing heated humidifiers (HHs) have been suggested to be a source of nasal burns in newborns treated with nasal CPAP. This study evaluated the risk of burns by reproducing 3 typical errors concerning the use of HHs. METHODS: Six HHs were tested on a bench in a traditional nasal CPAP setup: PMH5000, Aircon (Wilamed); MR730, MR850, MR950 (Fisher & Paykel); and H900 (Hamilton). Temperature was measured at the end of the inspiratory tubing limb. Errors tested were (1) misconnection of the HH thermal probes (NoProbe), (2) absence of gas flow while the HH is on (NoFlow), and (3) unsuitable repeated acknowledgment of the HH alarm (NoAlarm). These errors were combined in 3 standardized scenarios: (1) NoProbe + NoFlow + NoAlarm; (2) NoProbe + NoAlarm, and (3) NoFlow + NoAlarm. The NoProbe + NoFlow + NoAlarm and NoProbe + NoAlarm scenarios were not tested in the H900 and MR950 because the proprietary circuits of these HHs are equipped with embedded probes. RESULTS: For each HH, the highest inspiratory gas temperature (HIGT) and the rating on a self-designed risk-of-burn scale (ie, no risk, moderate risk, or severe risk) were reported. In the NoProbe + NoFlow + NoAlarm scenario, the risk was severe for the MR730, PMH5000, MR850, and Aircon, with HIGTs of > 65°C, 58°C, 56°C, and > 65°C, respectively. In the NoProbe + NoAlarm scenario, the risk was also severe for the same 4 HHs, with HIGTs of 56°C, 47°C, 56°C, and 48°C, respectively. In the NoFlow + NoAlarm scenario, the risk was severe for the PMH5000, Aircon, and H900, with HIGTs of 52°C, > 65°C, and 49°C, respectively, and moderate for the MR730, MR850, and MR950, with HIGTs of 45°C, 47°C, and 44°C, respectively). CONCLUSIONS: In case of misuse, 5 of the 6 tested devices presented a severe risk of inducing skin burns, whereas the MR950 presented a moderate risk. pubtype: Academic Journal doctype: CEU pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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