Safety of combined heat and moisture exchanger filters in long-term mechanical ventilation.

Details

Serval ID
serval:BIB_9CB0C785CDEE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Safety of combined heat and moisture exchanger filters in long-term mechanical ventilation.
Journal
Chest
Author(s)
Hurni J.M., Feihl F., Lazor R., Leuenberger P., Perret C.
ISSN
0012-3692
Publication state
Published
Issued date
1997
Peer-reviewed
Oui
Volume
111
Number
3
Pages
686-91
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Randomized Controlled Trial - Publication Status: ppublish
Abstract
STUDY OBJECTIVE: To evaluate the safety of a combined heat and moisture exchanger filter (HMEF) for the conditioning of inspired gas in long-term mechanical ventilation (MV). DESIGN: Randomized controlled trial. SETTING: Medical ICU in a large teaching hospital. PATIENTS: One hundred fifteen consecutive patients who required > or = 48 h of MV. INTERVENTIONS: Patients were randomized at intubation time (day 1) to receive inspired gas conditioned either by a water-bath humidifier heated at 32 degrees C (HWBH) or by an HMEF (Hygroster; DAR; Mirandola, Italy). MEASUREMENTS AND MAIN RESULTS: The two study groups were comparable in terms of primary pathologic condition at the time of hospital admission, disease severity as measured by the Simplified Acute Physiology Score, and ICU mortality. They did not differ with respect to ventilator days per patient (mean +/- SD: HMEF, 7.6 +/- 6.5; HWBH, 7.8 +/- 5.8), incidence of endotracheal tube obstruction (HMEF, 0/59; HWBH, 1/56), and incidence of hypothermic episodes (HMEF, five; HWBH, two). In 41 patients receiving MV for > or = 5 days, the morphologic integrity of respiratory epithelium was evaluated on day 1 and day 5, using a cytologic examination of tracheal aspirate smears. The state of ciliated epithelium was scored on a scale from 0 (poorest integrity) to 1,200 (maximum integrity), according to a well-described method. In both patient groups, the scores slightly but significantly decreased from day 1 to day 5 (mean +/- SD: HWBH, from 787 +/- 104 to 745 +/- 88; HMEF, from 813 +/- 79 to 739 +/- 62; p < 0.01 for both groups); there were no statistically significant differences between groups. CONCLUSIONS: These data indicate acceptable safety of HMEFs of the type used in the present study for long-term mechanical ventilation.
Keywords
Equipment Safety, Female, Humans, Humidity, Male, Middle Aged, Respiration, Artificial, Temperature, Time Factors, Trachea, Ventilators, Mechanical
Pubmed
Web of science
Create date
25/01/2008 9:38
Last modification date
20/08/2019 15:03
Usage data