Gas Humidification During Helmet Continuous Positive Airway Pressure: A Crossover Randomized Physiologic Study in Healthy Subjects.

Background: In the last decades, the use of the helmet interface to deliver noninvasive respiratory support has steadily increased. When delivering oxygen therapy, conditioning of inspired gas is mandatory, as the water content of medical gas is neglectable. To minimize the risk of airway damage, it...

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Published in:Dimensions of Critical Care Nursing Vol. 43; no. 1; pp. 21 - 28
Main Authors: Ambrosetti, Lorenzo, Giani, Marco, Rezoagli, Emanuele, Fiorillo, Chiara, Vitale, Daniela, Giacchè, Damiano, Ravasio, Giambattista, Fumagalli, Roberto, Foti, Giuseppe, Lucchini, Alberto
Format: pictorial research tables/charts randomized controlled trial Journal Article
Published: Lippincott Williams & Wilkins Jan/Feb2024
Online Access:View this record in EBSCOhost
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        07304625
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      dt: Jan/Feb2024
      vid: 43
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        10.1097/DCC.0000000000000616
        174099196
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        atl: Gas Humidification During Helmet Continuous Positive Airway Pressure: A Crossover Randomized Physiologic Study in Healthy Subjects.
      aug:
        au:
          Ambrosetti, Lorenzo
          Giani, Marco
          Rezoagli, Emanuele
          Fiorillo, Chiara
          Vitale, Daniela
          Giacchè, Damiano
          Ravasio, Giambattista
          Fumagalli, Roberto
          Foti, Giuseppe
          Lucchini, Alberto
        affil: Lorenzo Ambrosetti, MD, is resident at the School of Medicine and Surgery, University of Milano-Bicocca, Monza, General Intensive Care Unit–ASST Monza, San Gerardo Hospital.
      sug:
        subj:
          Humidity
          Continuous Positive Airway Pressure
          Human
          Randomized Controlled Trials
          Random Assignment
          Confidence Intervals
          Ventilation
          Descriptive Statistics
          Data Analysis Software
          Crossover Design
          Physiological Studies
          Post Hoc Analysis
      ab: Background: In the last decades, the use of the helmet interface to deliver noninvasive respiratory support has steadily increased. When delivering oxygen therapy, conditioning of inspired gas is mandatory, as the water content of medical gas is neglectable. To minimize the risk of airway damage, it is recommended to achieve an absolute humidity greater than 10 mg H2O/L. The primary aim of the study was to assess the performance of 3 different heated humidifiers to condition gas during helmet continuous positive airway pressure and to compare them with a setting without active humidification. Methods: We performed a crossover randomized physiological study in healthy volunteers. Absolute humidity, relative humidity, and temperature were measured during 4 steps (no humidification and the 3 heated humidifiers, performed in a randomized order) and at 3 time points (after 1, 5, and 10 minutes). Results: Eight subjects participated to the study. Without active humidification, absolute humidity was constantly below the recommended level. All humidifiers conditioned the inspired gases to an average absolute humidity greater than 10 mg H2O/L. Overall, the best performance, in terms of absolute humidity, was obtained with H900 (19.74 ± 0.50 mg H2O/L), followed by TurbH2O (−6.82 mg H2O/L vs H900; 95% confidence interval, −8.49 to −5.14; P <.05) and F&P 810 (−9.03 mg H2O/L vs H900; 95% confidence interval, −10.70 to −7.35; P <.05). Conclusions: Active humidification is required to achieve adequate conditioning of inspired gas during helmet continuous positive airway pressure. The choice between different humidifiers available on the market should be made according to the local needs and expertise.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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