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Intensive Care Med. 2002 Nov;28(11):1590-4. Epub 2002 Sep 6.

Comparison of the effects of heat and moisture exchangers and heated humidifiers on ventilation and gas exchange during non-invasive ventilation.

Author information

1
Unité de Réanimation et de Transplantation-Département d'Anesthésie-Réanimation B, CHU de Montpellier Hôpital Saint Eloi, 80 avenue Augustin Fliche, 34295 Montpellier Cedex, France. jaber@creteil.inserm.fr

Abstract

OBJECTIVE:

To compare the short-term effects of a heat and moisture exchanger (HME) and a heated humidifier (HH) during non-invasive ventilation (NIV).

DESIGN:

Prospective, clinical investigation.

SETTING:

Intensive care unit of a university hospital.

PATIENTS:

Twenty-four patients with acute respiratory failure (ARF).

INTERVENTION:

Each patient was studied with a HME and a HH in a random order during two consecutive 20min periods of NIV.

MEASUREMENTS AND RESULTS:

Respiratory rate (RR), expiratory tidal volume (VTe) and expiratory minute ventilation (VE) were measured during the last 5 min of each period and blood gases were measured. Mean pressure support and positive end-expiratory pressure levels were, respectively, 15+/-4 and 6+/-2 cmH(2)O. VE was significantly greater with HME than with HH (14.8+/-4.8 vs 13.2+/-4.3 l/min; p<0.001). This increase in VE was the result of a greater RR for HME than for HH (26.5+/-10.6 vs 24.1+/-9.8 breaths/min; p=0.002), whereas the VT for HME was similar to that for HH (674+/-156 vs 643+/-148 ml; p=0.09). Arterial partial pressure of carbon dioxide (PaCO(2)) was significantly higher with a HME than with a HH (43.4+/-8.9 vs 40.8+/-8.2 mmHg; p<0.005), without significantly changing oxygenation.

CONCLUSION:

During NIV the increased dead space of a HME can negatively affect ventilatory function and gas exchange. The effect of HME dead space may decrease efficiency of NIV in patients with ARF.

PMID:
12415445
DOI:
10.1007/s00134-002-1441-0
[Indexed for MEDLINE]

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