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Small dead space heat and moisture exchangers do not impede gas exchange during noninvasive ventilation: a comparison with a heated humidifier

Alexandre Boyer| Frederic Vargas| Gilles Hilbert| Didier Gruson| Maud Mousset-Hovaere| Yves Castaing| Didier Dreyfuss| Jean Damien Ricard
Original
Volume 36, Issue 8 / August , 2010

Pages 1348 - 1354

Abstract

Objective

Adverse respiratory and gasometrical effects have been described in patients with acute respiratory failure (ARF) undergoing noninvasive ventilation (NIV) with standard heat and moisture exchangers (HME). We decided to evaluate respiratory parameters and arterial blood gases (ABG) of patients during NIV with small dead space HME compared with heated humidifier (HH).

Design

Prospective randomized crossover study.

Setting

A 16-bed medical intensive care unit (ICU).

Patients

Fifty patients receiving NIV for ARF.

Measurements

The effects of HME and HH on respiratory rate, minute ventilation, EtCO2, oxygen saturation, airway occlusion pressure at 0.1 s, ABG, and comfort perception were compared during two randomly determined NIV periods of 30 min. The relative impact of HME and HH on these parameters was successively compared with or without addition of a flex tube (40 and 10 patients, respectively).

Main results

No difference was observed between HME and HH regarding any of the studied parameters, whether or not a flex tube was added.

Conclusion

If one decides to humidify patients’ airways during NIV, one may do so with small dead space HME or HH without altering respiratory parameters.

Keywords

References

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