Document Detail


Effect of the humidification device on the work of breathing during noninvasive ventilation.
MedLine Citation:
PMID:  12415444     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Heat and moisture exchangers (HME) increase circuitry deadspace compared to heated humidifiers (HH). This study compared the effect of HH and HME during noninvasive ventilation (NIV) on arterial blood gases and patient's effort assessed by respiratory muscles pressure-time product and by work of breathing (WOB). DESIGN AND SETTING: Randomized cross-over study in a medical intensive care unit. PATIENTS: Nine patients receiving NIV for moderate to severe acute hypercapnic respiratory failure. MEASUREMENTS: HME was randomly compared to HH during periods of 20 min. Each device was studied without (ZEEP) and with a PEEP of 5 cmH(2)O. At the end of each period arterial blood gases, ventilatory parameters, oesophageal and gastric pressures were recorded and indexes of patient's effort calculated. RESULTS: Minute ventilation was significantly higher with HME than with HH (ZEEP: 15.8+/-3.7 vs. 12.8+/-3.6 l/min) despite a similar PaCO(2) (60+/-16 vs. 57+/-16 mmHg). HME was associated with a greater increase in WOB (ZEEP: 15.5+/-7.7 vs. 8.4+/-4.5 J/min and PEEP: 11.3+/-5.7 vs. 7.3+/-3.8 J/min) and indexes of patient effort. NIV with HME failed to decrease WOB compared to baseline. Addition of PEEP reduced the level of effort, but similar differences between HME and HH were observed. CONCLUSIONS: In patients receiving NIV for moderate to severe acute hypercapnic respiratory failure, the use of HME lessens the efficacy of NIV in reducing effort compared to HH.
Authors:
François Lellouche; Salvatore M Maggiore; Nicolas Deye; Solenne Taillé; Jérôme Pigeot; Alain Harf; Laurent Brochard
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2002-10-10
Journal Detail:
Title:  Intensive care medicine     Volume:  28     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-04     Completed Date:  2003-05-20     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1582-9     Citation Subset:  IM    
Affiliation:
Medical Intensive Care Unit, Hôpital Henri Mondor, AP-HP, Université Paris 12 et INSERM U492, 51 av du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Blood Gas Analysis
Cross-Over Studies
Female
Hot Temperature
Humans
Humidity*
Intensive Care Units
Male
Middle Aged
Monitoring, Physiologic
Positive-Pressure Respiration
Respiration, Artificial / methods*
Respiratory Insufficiency / physiopathology,  therapy*
Statistics, Nonparametric
Treatment Outcome
Work of Breathing*

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