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Short-term Effects of Humidification Devices on Respiratory Pattern and Arterial Blood Gases During Noninvasive Ventilation.
MedLine Citation:
PMID:  22417382     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The impact of the 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 (HME) and heated humidifiers (HH) during NIV for either hypercapnic or hypoxemic acute respiratory failure. METHODS: Consecutive patients receiving NIV were successively treated with HME and HH in randomized order for 30 minutes each. At the end of each period, arterial blood gases were measured and ventilatory parameters were recorded. RESULTS: Eighty-one patients were enrolled, of which 52 were hypercapnic (with or without acidosis) and 29 hypoxemic. Minute-ventilation was greater with the HME in comparison with the HH (15.5 ± 6.4 vs. 13.7 ± 5.8 l/min, P<0.001), while PaCO₂ was increased when using HME, indicating a dead space effect. This effect was observed in all patients, but was more pronounced in hypercapnic patients (PaCO₂ 63 ± 18 mmHg with HME vs. 57 ± 14 with HH, P<0.001). In a subgroup of 19 patients 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. CONCLUSION: Use of an HME decreased CO₂ elimination during noninvasive ventilation despite increased minute ventilation, especially in hypercapnic patients.
Authors:
François Lellouche; Claudia Pignataro; Salvatore Maurizio Maggiore; Emmanuelle Girou; Nicolas Deye; Solenne Taillé; Marc Fischler; Laurent Brochard
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-13
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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