Document Detail


Short-term effects of humidification devices on respiratory pattern and arterial blood gases during noninvasive ventilation.
MedLine Citation:
PMID:  22417382     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The impact of humidification devices on ventilatory and arterial blood gases parameters during noninvasive ventilation (NIV) remains controversial. The aim of the study was to compare the short-term impact of heat and moisture exchangers (HMEs) and heated humidifiers (HHs) during NIV for either hypercapnic or hypoxemic acute respiratory failure.
METHODS: Consecutive subjects receiving NIV were successively treated with HME and HH in randomized order for 30 min each. At the end of each period, arterial blood gases were measured and ventilatory parameters were recorded.
RESULTS: Eighty-one subjects were enrolled, of whom 52 were hypercapnic (with or without acidosis) and 29 hypoxemic. Minute ventilation was greater with the HME, in comparison with the HH (15 [12-18] vs 12 [10-16] median [interquartile range], P < .001), while P(aCO(2)) was increased when using HME, indicating a dead space effect. This effect was observed in all subjects, but was more pronounced in hypercapnic subjects (P(aCO(2)) 62 ± 17 mm Hg with HME vs 57 ± 14 with HH, P < .001). In a subgroup of 19 subjects with respiratory acidosis, alveolar hypoventilation improved only with the HH. The amplitude of the dead space impact was a function of the degree of hypercapnia.
CONCLUSIONS: Use of an HME decreased CO(2) elimination during NIV, despite increased minute ventilation, especially in hypercapnic subjects.
Authors:
François Lellouche; Claudia Pignataro; Salvatore Maurizio Maggiore; Emmanuelle Girou; Nicolas Deye; Solenne Taillé; Marc Fischler; Laurent Brochard
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2012-03-13
Journal Detail:
Title:  Respiratory care     Volume:  57     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-30     Completed Date:  2013-01-07     Revised Date:  2013-08-08    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1879-86     Citation Subset:  IM    
Affiliation:
Service de Réanimation Médicale, Assistance Publique Hôpitaux de Paris, Centre Hospitalier Albert Chenevier-Henri Mondor, Créteil, France. francois.lellouche@criucpq.ulaval.ca
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MeSH Terms
Descriptor/Qualifier:
Blood Gas Analysis
Carbon Dioxide / metabolism
Female
Hot Temperature
Humans
Humidity
Hydrogen-Ion Concentration
Linear Models
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive / physiopathology,  therapy*
Respiration, Artificial / instrumentation*
Respiratory Dead Space
Respiratory Function Tests
Statistics, Nonparametric
Treatment Outcome
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide
Comments/Corrections
Comment In:
Respir Care. 2013 Mar;58(3):e35-6   [PMID:  23443290 ]
Respir Care. 2013 Mar;58(3):e36-8

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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