Effect of Humidifier Temperature During Non-invasive Ventilation on Water Condensate and Airway Pressure: Newborn Manikin Model
Keywords:Humidifier, Non-invasive ventilation
Recommendation for setting humidifier temperature when using non-invasive ventilation in newborn infants has been changed from low range (32-34 C) to high rang (37 C). However, there is no evidence comparing benefit and hazard between the two settings. To compare the effect of two temperature settings of humidifier during non-invasive ventilation on nasopharyngeal temperature, water condensate and airway pressure. We applied nasal intermittent positive pressure ventilation in a newborn manikin with artificial lungs. The temperature of humidifier was set at high range or low range. We measured nasopharyngeal temperature, water condensate in ventilator circuit and airway pressure in an artificial lung at 0, 8 and 16 hours after starting ventilation. The experiments were conducted 3 times for each setting of humidifier. Comparisons between the groups were analyzed by using Peason’s correlation. Nasopharyngeal temperature with humidifier temperature at high range 34.0 +- 0.1 C was significantly higher than that at low range 32.1 +- 0.2 C (p < 0.001). Volume of water condensate in ventilator circuit was strongly correlated with airway pressure in artificial lungs (r= - 0.828 for PIP, r= -0.948 for PEEP). Water condensate in ventilator circuit significantly decreased airway pressure and interfered with ventilator function. When using non-invasive ventilation, setting humidifier temperature at high range produces substantial water condensate resulting in significantly decreased airway pressure. Therefore, water drainage should be emphasized as an important respiratory care. Funding: Phramongkutklao Foundation
Gross JL, Park GR. Humidification of inspired gases during mechanical ventilation. Minerva Anestesiol. 2012;78(4):496-502.
Branson RD, Gentile MA. Is humidification always necessary during noninvasive ventilation in the hospital. Respir Care 2010;55(2):209-16.
Williams R, Rankin N, Smith T, Galler D, Seakins P. Relationship between the humidity and temperature of inspired gas and the function of the airway mucosa. Crit Care Med. 1996;24(11):1920-9. DOI: https://doi.org/10.1097/00003246-199611000-00025
American Association for Respiratory Care, Restrepo RD, Walsh BK. Humidification during invasive and noninvasive mechanical ventilation: 2012. Respir Care. 2012; 57(5):782-8. DOI: https://doi.org/10.4187/respcare.01766
Lellouche F, Maggiore SM, Deye N, Taillé S, Pigeot J, Harf A, Brochard L. Effect of the humidification device on the work of breathing during noninvasive ventilation. Intensive Care Med. 2002;28(11):1582-9. DOI: https://doi.org/10.1007/s00134-002-1518-9
Davies MW, Dunster KR, Cartwright DW. Inspired gas temperature in ventilated neonates. Pediatr Pulmonol. 2004;38(1):50-4. DOI: https://doi.org/10.1002/ppul.20036
Tarnow-Mordi WO, Reid E, Griffiths P, Wilkinson AR. Low inspired gas temperature and respiratory complications in very low birth weight infants. J Pediatr.1989;114(3):438-42. DOI: https://doi.org/10.1016/S0022-3476(89)80567-0
Jardine LA, Dunster KR, Davies MW. An experimental model for the measurement of inspired gas temperatures in ventilated neonates. Pediatr Pulmonol.2008;43(1):29-33. DOI: https://doi.org/10.1002/ppul.20731
Youngquist TM, Richardson CP, DiBlasi RM. Effects of condensate in the exhalation limb of neonatal circuits on airway pressure during bubble CPAP. Respir Care 2013;58(11):1840-6. DOI: https://doi.org/10.4187/respcare.02322
Todd DA, Boyd J, Lloyd J, John E. Inspired gas temperature during mechanical ventilation: effects of environmental temperature and airway temperature probe position. J Paediatr Child Health 2001:37(5):495-500. DOI: https://doi.org/10.1046/j.1440-1754.2001.00749.x
O'Hagan M, Reid E, Tarnow-Mordi WO. Is neonatal inspired gas humidity accurately controlled by humidifier temperature? Crit Care Med. 1991;19(11):1370-3. DOI: https://doi.org/10.1097/00003246-199111000-00012
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