Changing heat and moisture exchangers every 48 hours rather than 24 hours does not affect their efficacy and the incidence of nosocomial pneumonia
| Autor: | Patrick Brun, Philippe Markowicz, Laurence Mier, M Billiard, Didier Dreyfuss, Philippe Estagnasie, Kamel Djedaini, Yves Boussougant, François Coste, G Le Bourdelles |
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| Rok vydání: | 1995 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Artificial ventilation Time Factors Cost-Benefit Analysis medicine.medical_treatment Critical Care and Intensive Care Medicine Tracheal tube Pneumonia Bacterial medicine Humans Prospective Studies Aged Mechanical ventilation Cross Infection business.industry Incidence Incidence (epidemiology) Middle Aged medicine.disease Respiration Artificial Pneumonia Evaluation Studies as Topic Anesthesia Equipment Contamination Female Safety Airway Complication business Respiratory minute volume |
| Zdroj: | American Journal of Respiratory and Critical Care Medicine. 152:1562-1569 |
| ISSN: | 1535-4970 1073-449X |
| DOI: | 10.1164/ajrccm.152.5.7582295 |
| Popis: | Heat and moisture exchangers (HME) (Dar-Hygrobac II, Peters) can safely be used every 24 h for long-term mechanical ventilation and provide a cost-saving alternative to heated humidifiers. We have prospectively determined whether changing HMEs every 48 h only affects their clinical and bacteriological efficiency in a series of consecutive nonselected ICU patients requiring long-term mechanical ventilation. Two consecutive periods were compared. During period 1, HMEs were replaced every day; during period 2, they were changed every 48 h. Patients from the two periods were similar in terms of age and indication for and overall duration of MV (10 +/- 8.6 versus 10 +/- 9 d, p = 0.9). Minute ventilation and maximum values for peak airway pressure were identical during the two periods. These values were also identical after 1 and 2 d of HME use during period 2, indicating that HME resistance was not increased by prolonged use. Obstruction of the tracheal tube occurred only once in a period 1 patient. The results of quantitative cultures indicate that the maximum and mean levels of bacterial colonization during the two periods were similar for the pharynx, trachea, Y-connector, patient, and ventilator side of the HME. More importantly, the incidence of nosocomial pneumonia was similar during the two periods (6/61 versus 8/68, p = 0.7). Thus, prolonged HME use is safe and provides a substantial reduction in the cost of mechanical ventilation. |
| Databáze: | OpenAIRE |
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