Insufficient Humidification of Respiratory Gases in Patients Who Are Undergoing Therapeutic Hypothermia at a Paediatric and Adult Intensive Care Unit.
Insufficient Humidification of Respiratory Gases in Patients Who Are Undergoing Therapeutic Hypothermia at a Paediatric and Adult Intensive Care Unit.
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DOI：
10.1155/2017/8349874
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发表时间：
2017
影响因子：
2.2
通讯作者：
Iwata O
中科院分区：
文献类型：
--
作者：
Tanaka Y;Iwata S;Kinoshita M;Tsuda K;Tanaka S;Hara N;Shindou R;Harada E;Kijima R;Yamaga O;Ohkuma H;Ushijima K;Sakamoto T;Yamashita Y;Iwata O
对于冷却的新生儿，常温条件下的湿化器设置提供了过量的气体湿度，因为饱和时的绝对湿度取决于温度。为了评估在儿科/成人重症监护室接受中度低温治疗的患者的呼吸气体加湿，对6例患者进行了9次以上的研究。测试了三种加湿器设置，37-默认值（腔室出口，37°C; Y形件，40°C）、33.5-理论值（腔室出口，33.5°C; Y形件，36.5°C）和33.5-调整值（优化设置，使用来自温湿度计的反馈在33.5°C下实现饱和蒸汽）。评估了Y形件气体温度/湿度以及相对于目标水平（36.6 mg/L）的高湿度（>40.6 mg/L）和低湿度（<32.9 mg/L）的发生率。对于37-默认设置、33.5-理论设置和33.5-调整设置，Y形件气体湿度分别为32.0（26.8-37.3）、22.7（16.9-28.6）和36.9（35.5-38.3）mg/L {平均值（95%置信区间）}。在37默认设置的1例患者中观察到高湿度，而在37默认设置的5例患者和33.5理论设置的8例患者中观察到低湿度。使用33.5调整设置，未观察到Y形件湿度不足。在儿科/成人重症监护室冷却的患者中，强调了呼吸气体湿化不足的默认湿化器设置的潜在风险。Y形件气体条件可以通过调整Y形件气体温度/湿度引导的设置来控制到理论上的最佳水平。
For cooled newborn infants, humidifier settings for normothermic condition provide excessive gas humidity because absolute humidity at saturation is temperature-dependent. To assess humidification of respiratory gases in patients who underwent moderate therapeutic hypothermia at a paediatric/adult intensive care unit, 6 patients were studied over 9 times. Three humidifier settings, 37-default (chamber-outlet, 37°C; Y-piece, 40°C), 33.5-theoretical (chamber-outlet, 33.5°C; Y-piece, 36.5°C), and 33.5-adjusted (optimised setting to achieve saturated vapour at 33.5°C using feedback from a thermohygrometer), were tested. Y-piece gas temperature/humidity and the incidence of high (>40.6 mg/L) and low (<32.9 mg/L) humidity relative to the target level (36.6 mg/L) were assessed. Y-piece gas humidity was 32.0 (26.8–37.3), 22.7 (16.9–28.6), and 36.9 (35.5–38.3) mg/L {mean (95% confidence interval)} for 37-default setting, 33.5-theoretical setting, and 33.5-adjusted setting, respectively. High humidity was observed in 1 patient with 37-default setting, whereas low humidity was seen in 5 patients with 37-default setting and 8 patients with 33.5-theoretical setting. With 33.5-adjusted setting, inadequate Y-piece humidity was not observed. Potential risks of the default humidifier setting for insufficient respiratory gas humidification were highlighted in patients cooled at a paediatric/adult intensive care unit. Y-piece gas conditions can be controlled to the theoretically optimal level by adjusting the setting guided by Y-piece gas temperature/humidity.