Long-term mechanical ventilation with hygroscopic heat and moisture exchangers used for 48 hours: A prospective clinical, hygrometric, and bacteriologic study

Critical Care Medicine

Volumn 31, Issue 3, 2003, Pages 823-829

  Boyer, Alexandre ^a   Thiéry, Guillaume ^a   Lasry, Serge ^a   Pigné, Etienne ^a   Salah, Amar ^a   De Lassence, Arnaud ^a   Dreyfuss, Didier ^a   Ricard, Jean Damien ^a  

^a HÔPITAL LOUIS MOURIER   (France)

Author keywords

Absolute humidity; Acute respiratory failure; Chronic obstructive pulmonary disease; Heat and moisture exchanger; Humidification of inspired gases; Mechanical ventilation

Indexed keywords

ACUTE RESPIRATORY FAILURE; ADULT; ARTICLE; ARTIFICIAL VENTILATION; BACTERIAL COLONIZATION; CHRONIC OBSTRUCTIVE LUNG DISEASE; ENDOTRACHEAL INTUBATION; FEMALE; HEAT EXCHANGE; HUMAN; HUMIDIFIER; HUMIDITY; MAJOR CLINICAL STUDY; MALE; MEASUREMENT; MICROBIOLOGICAL EXAMINATION; MOISTURE; PRIORITY JOURNAL; PROSPECTIVE STUDY; WETTABILITY;

AGED; COLONY COUNT, MICROBIAL; COST CONTROL; DISPOSABLE EQUIPMENT; EQUIPMENT CONTAMINATION; EQUIPMENT DESIGN; FEMALE; HUMANS; HUMIDITY; INFECTION CONTROL; LONG-TERM CARE; MALE; MIDDLE AGED; NEBULIZERS AND VAPORIZERS; PROSPECTIVE STUDIES; PULMONARY DISEASE, CHRONIC OBSTRUCTIVE; RESPIRATION, ARTIFICIAL; RESPIRATORY INSUFFICIENCY; SAFETY; SPUTUM; TIME FACTORS; TRACHEA; TREATMENT OUTCOME; WETTABILITY;

EID: 0037348565     PISSN: 00903493     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.CCM.0000055382.87129.DD     Document Type: Article

References (43)

1. Forbes AR: Temperature, humidity and mucus flow in the intubated trachea. Br J Anaesth 1974; 46:29-34
2. Chalon J, Patel C, Ali M, et al: Humidity and the anesthetized patient. Anesthesiology 1979; 50:195-198
3. Cook D, Ricard JD, Reeve B, et al: Ventilator circuit and secretion management strategies: A Franco-Canadian survey. Crit Care Med 2000; 28:3547-3554
4. Tenaillon A, Cholley G, Boiteau R, et al: Filtres échangeurs de chaleur et d'humidité versus humidificateurs chauffant en ventilation mécanique. Réanim Soins Intens Méd Urg 1989; 5:5-10
5. Dreyfuss D, Djedaini K, Gros I, et al: Mechanical ventilation with heated humidifiers or heat and moisture exchangers: Effects on patient colonization and incidence of nosocomial pneumonia. Am J Respir Crit Care Med 1995; 151:986-992
6. Hurni JM, Feihl F, Lazor R, et al: Safety of combined heat and moisture exchanger filters in long-term mechanical ventilation. Chest 1997; 111:686-691
7. Martin C, Papazian L, Perrin G, et al: Performance evaluation of three vaporizing humidifiers and two heat and moisture exchangers in patients with minute ventilation >10 L/min. Chest 1992; 102:1347-1350
8. Jackson C, Webb AR: An evaluation of the heat and moisture exchange performance of four ventilator circuit filters. Intensive Care Med 1992; 18:264-268
9. Sottiaux T, Mignolet G, Damas P, et al: Comparative evaluation of three heat and moisture exchangers during short-term postoperative mechanical ventilation. Chest 1993; 104:220-224
10. Martin C, Thomachot L, Quinio B, et al: Comparing two heat and moisture exchangers with one vaporizing humidifier in patients with minute ventilation greater than 10 L/min. Chest 1995; 107:1411-1415
11. Ricard JD, Markowicz P, Djedaïni K, et al: Bedside evaluation of efficient airway humidification during mechanical ventilation of the critically ill. Chest 1999; 115:1646-1652
12. Kollef M, Shapiro S, Boyd V, et al: A randomized clinical trial comparing an extended-use hygroscopic condenser humidifier with heated-water humidification in mechanically ventilated patients. Chest 1998; 113:759-767
13. Branson RD, Davis KJ, Brown R, et al: Comparison of three humidification techniques during mechanical ventilation: Patient selection, cost, and infection considerations. Respir Care 1996; 41:809-816
14. Boots RJ, Howe S, George N, et al: Clinical utility of hygroscopic heat and moisture exchangers in intensive care patients. Crit Care Med 1997; 25:1707-1712
15. Kirton O, DeHaven B, Morgan J, et al: A prospective, randomized comparison of an in-line heat and moisture exchange filter and heated wire humidifiers: Rates of ventilator-associated early-onset (community-acquired) or late-onset (hospital-acquired) pneumonia and incidence of endotracheal tube occlusion. Chest 1998; 112:1055-1059
16. Thomachot L, Vialet R, Viguier JM, et al: Efficacy of heat and moisture exchangers after changing every 48 hours rather than 24 hours. Crit Care Med 1998; 26:477-481
17. Cohen IL, Weinberg PF, Fein IA, et al: Endotracheal tube occlusion associated with the use of heat and moisture exchangers in the intensive care unit. Crit Care Med 1988; 16:277-279
18. Martin C, Perrin G, Gevaudan MJ, et al: Heat and moisture exchangers and vaporizing humidifiers in the intensive care unit. Chest 1990; 97:144-149
19. Misset B, Escudier B, Rivara D, et al: Heat and moisture exchanger vs heated humidifier during long-term mechanical ventilation: A prospective randomized study. Chest 1991; 100:160-163
20. Roustan JP, Kienlen J, Aubas P, et al: Comparison of hydrophobic heat and moisture exchangers with heated humidifier during prolonged mechanical ventilation. Intensive Care Med 1992; 18:97-100
21. Villafane MC, Cinnella G, Lofaso F, et al: Gradual reduction of endotracheal tube diameter during mechanical ventilation via different humidification devices. Anesthesiology 1996; 85:1341-1349
22. Davis K Jr, Evans SL, Campbell RS, et al: Prolonged use of heat and moisture exchangers does not affect device efficiency or frequency rate of nosocomial pneumonia. Crit Care Med 2000; 28:1412-1418
23. Lee MG, Ford JL, Hunt PB, Ireland DS, et al: Bacterial retention properties of heat and moisture exchange filters. Br J Anaesth 1992; 69:522-525
24. Leijten DT, Rejger VS, Mouton RP: Bacterial contamination and the effect of filters in anaesthetic circuits in a simulated patient model. J Hosp Infect 1992; 21:51-60
25. Ricard JD, Dreyfuss D: Circuit changes: "Wu wei" may save time, labor and money [editorial]. Respir Care 2001; 46:888-890
26. Djedaïni K, Billiard M, Mier L, et al: Changing heat and moisture exchangers every 48 hour rather than every 24 hour does not affect their efficacy and the incidence of nosocomial pneumonia. Am J Respir Crit Care Med 1995; 152:1562-1569
27. Markowicz P, Ricard JD, Dreyfuss D, et al: Safety, efficacy and cost effectiveness of mechanical ventilation with humidifying filters changed every 48 hours: A prospective, randomized study. Crit Care Med 2000; 28:665-671
28. Ricard JD, Le Mière E, Markowicz P, et al: Efficiency and safety of mechanical ventilation with a heat and moisture exchanger changed only once a week. Am J Respir Crit Care Med 2000; 161:104-109
29. Thomachot L, Leone M, Razzouk K, et al: Randomized clinical trial of extended use of a hydrophobic condenser humidifier: 1 vs. 7 days. Crit Care Med 2002; 30:232-237
30. Thomachot L, Viviand X, Arnaud S, et al: Comparing two heat and moisture exchangers, one hydrophobic and one hygroscopic, on humidifying efficacy and the rate of nosocomial pneumonia. Chest 1998; 114:1383-1389
31. Le Gall JR, Loirat P, Alperovitch A, et al: A simplified acute physiology score for ICU patients. Crit Care Med 1984; 12:975-977
32. Dreyfuss D, Djedaini K, Weber P, et al: Prospective study of nosocomial pneumonia and of patient and circuit colonization during mechanical ventilation with circuit changes every 48 hours versus no change. Am Rev Respir Dis 1991; 143:738-743
33. Craven DE, Goularte TA, Make BJ: Contaminated condensate in mechanical ventilator circuits: A risk factor for nosocomial pneumonia. Am Rev Respir Dis 1984; 129:625-628
34. Branson RD, Campbell RS: Humidification in the ICU. Respir Care Clin North Am 1998; 4:320
35. Richards G: The role of filtration during humidification. Respir Care Clin North Am 1998; 4:329-339
36. Hess D: Prolonged use of heat and moisture exchangers: Why do we keep changing things? Crit Care Med 2000; 28:1667-1668
37. Kollef M: The prevention of ventilator-associated pneumonia. N Engl J Med 1999; 340:627-634
38. Branson RD, Davis KJ, Campbell RS, et al: Humidification in the intensive care unit: Prospective study of a new protocol utilizing heated and humidification and a hygroscopic condenser humidifier. Chest 1993; 104:1800-1805
39. Branson RD, Davis KJ: Evaluation of 21 passive humidifiers according to the ISO 9360 standard: Moisture output, dead space, and flow resistance. Respir Care 1996; 41:736-743
40. Pelosi P, Solca M, Ravagnan I, et al: Effects of heat and moisture exchangers on minute ventilation, ventilatory drive, and work of breathing during pressure-support ventilation in acute respiratory failure. Crit Care Med 1996; 24:1184-1188
41. Le Bourdelles G, Mier L, Fiquet B, et al: Comparison of the effects of heat and moisture exchangers and heated humidifiers on ventilation and gas exchange during weaning trials from mechanical ventilation. Chest 1996; 110:1294-1298
42. Iotti GA, Olivei MC, Palo A, et al: Unfavorable mechanical effects of heat and moisture exchangers in ventilated patients. Intensive Care Med 1997; 23:399-405
43. Campbell RS, Davis K Jr, Johannigman JA, et al: The effects of passive humidifier dead space on respiratory variables in paralyzed and spontaneously breathing patients. Respir Care 2000; 45:306-312