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Short-Term Effects of an Active Heat-and-Moisture Exchanger During Invasive Ventilation.
Schreiber, Annia F; Ceriana, Piero; Ambrosino, Nicolino; Piran, Manuela; Malovini, Alberto; Carlucci, Annalisa.
Afiliación
  • Schreiber AF; Respiratory Intensive Care Unit, and Pulmonary Rehabilitation Unit, Istituti Clinici Scientifici Maugeri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Scientifico di Pavia, Pavia, Italy. annia.schreiber@icloud.com.
  • Ceriana P; Division of Respirology, Department of Medicine, University Health Network, Toronto, Ontario, Canada.
  • Ambrosino N; Respiratory Intensive Care Unit, and Pulmonary Rehabilitation Unit, Istituti Clinici Scientifici Maugeri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Scientifico di Pavia, Pavia, Italy.
  • Piran M; Istituti Clinici Scientifici Maugeri IRCCS, Istituto Scientifico di Montescano, Montescano Pavia, Italy.
  • Malovini A; Respiratory Intensive Care Unit, and Pulmonary Rehabilitation Unit, Istituti Clinici Scientifici Maugeri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Scientifico di Pavia, Pavia, Italy.
  • Carlucci A; Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri IRCCS, Istituto Scientifico di Pavia, Pavia, Italy.
Respir Care ; 64(10): 1215-1221, 2019 Oct.
Article en En | MEDLINE | ID: mdl-31270176
BACKGROUND: Humidification is a standard of care during invasive mechanical ventilation. Two types of devices are used for this purpose: heated humidifiers and heat-and-moisture exchangers (HME). AIM: To compare the short-term physiologic effects of an active HME, with those of heated humidifiers and HMEs in terms of respiratory effort, ventilatory pattern, and arterial blood gases during invasive mechanical ventilation. METHODS: We conducted a randomized crossover study with 3 different devices in 15 stable subjects who had a tracheostomy and were ventilator-dependent. Transdiaphragmatic pressure, ventilatory pattern, arterial blood gases, and dyspnea scale were recorded at baseline and at the end of a 20-min period with each device. RESULTS: Compared with heated humidifiers, the active HME was associated with higher diaphragmatic pressure-time product per minute (117.10 [interquartile range {IQR} 34.58-298.60]) versus 80.86 (IQR, 25.46-110.55) cm H2O×s/min, P = .01), higher PaCO2 (48.50 [IQR, 40.65-53.70] vs 39.60 [IQR, 37.50-49.95]) mm Hg, P = .02) and lower pH (7.41 [IQR, 7.36-7.49] vs 7.45 [IQR, 7.40-7.51], P = .030) without any significant difference in ventilatory pattern. A significantly worse dyspnea scale score (active HME, 3 (2-4) vs heated humidifiers: 4 (3-5); P = .009) was also observed. No significant differences were seen between active HME and HME. CONCLUSIONS: This study indicated that, compared with the heated humidifiers, the use of the active HME or the HME increased inspiratory effort, PaCO2 , pH, and dyspnea in stable subjects who were tracheostomized and ventilator-dependent. (ClinicalTrials.gov registration NCT02499796.).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Respiración Artificial / Trabajo Respiratorio / Humidificadores Tipo de estudio: Clinical_trials Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Respir Care Año: 2019 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Respiración Artificial / Trabajo Respiratorio / Humidificadores Tipo de estudio: Clinical_trials Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Respir Care Año: 2019 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos