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Respir Care. 2014 Jan;59(1):46-53. doi: 10.4187/respcare.02214. Epub 2013 Jun 13.

Heated humidification improves clinical outcomes, compared to a heat and moisture exchanger in children with tracheostomies.

Author information

1
Department of Paediatrics, Child and Youth Health, University of Auckland, and with Starship Children's Hospital, Grafton, Auckland, New Zealand.

Abstract

BACKGROUND:

The upper airway humidifies and warms inspired gases before they reach the trachea, a process bypassed by the insertion of a tracheostomy, necessitating humidification of inspired gases. The optimal method of humidification is not known.

METHODS:

We conducted a short-term 20-hour study and a long-term 10-week randomized crossover study comparing a heated humidifier (HH) to a heat and moisture exchanger (HME) in children with established tracheostomies. Subjects were assessed for clinical events, clinical examination findings, airway cytokine levels, and airway secretion viscoelasticity.

RESULTS:

For the short-term study, 15 children were recruited; for the long-term study, 14 children were recruited. Children using the HH had decreased respiratory examination score (P < .001) but no change in clinical events over the short term. There was a decrease in acute clinical events (P = .008) in the long-term study. No differences were found in airway secretion viscoelasticity results or cytokine levels in either study, but these sample numbers were limited.

CONCLUSIONS:

Over 20 hours use, HH, compared to HME, improved work of breathing. Over a longer 10 week treatment period HH resulted in decreased adverse clinical events.

KEYWORDS:

child; humidity; inflammation; mucociliary clearance; randomized controlled trial; rheology; tracheostomy

PMID:
23764867
DOI:
10.4187/respcare.02214
[Indexed for MEDLINE]
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