Clinical factors affecting inspired gas humidification and oral dryness during noninvasive ventilation
Clinical factors affecting inspired gas humidification and oral dryness during noninvasive ventilation
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DOI：
10.1016/j.jcrc.2010.10.005
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发表时间：
2011-10-01
影响因子：
3.7
通讯作者：
Nishimura, Masaji
中科院分区：
文献类型：
--
作者：
Oto, Jun;Imanaka, Hideaki;Nishimura, Masaji
目的：口腔干燥是无创通气（NIV）过程中常见的并发症。我们测量了患者的口腔干燥，并进行了实验室研究，以探讨相关因素加湿NIV。材料和方法：患者被随机分为2组：中（中组）和最大（最大组）加热加湿器（HH）设置。使用口腔湿度检查装置测量口腔干燥度，并在NIV开始后0、12和24小时以及NIV停止后12和24小时使用0至10的数字评定量表（NRS）评价口腔干燥感。进行了一项实验室研究，以评估呼气末正压（PEEP）、吸入氧分数（F（I）O（2））和漏气对绝对湿度的影响。我们评估了3种HH设置：无HH、中等设置的HH和最大设置的HH。在出口腔中的温度为31摄氏度至32摄氏度的中HH设置和38摄氏度至41摄氏度的最大HH setting.Results：在临床研究中，12例患者被分配到中组和11到最大组。Med组12、24小时口腔黏膜光滑度较0小时下降，NRS较0小时增加（P <0.05）。在Max组中，在整个研究期间，口腔湿度和NRS都没有变化，而在实验室研究中，高F（I）O（2），高PEEP和漏气降低了两种HH设置的绝对湿度（P <0.01）。然而，由于F（I）O（2）和PEEP的范围较窄，这些因素对患者口干的影响程度尚不清楚。HH设置显著影响NIV期间的加湿和口腔干燥。(c)2011 Elsevier Inc. All rights reserved.
Purpose: Oral dryness is a common complication during noninvasive ventilation (NIV). We measured the oral dryness of patients and performed a bench study to investigate factors related to humidification during NIV.Materials and Methods: Patients were randomly assigned into 2 groups: medium (Med group) and maximum (Max group) heated humidifier (HH) settings. Oral moistness was measured using an oral moisture-checking device, and the feeling of oral dryness was evaluated using a 0 to 10 numerical rating scale (NRS) at 0, 12, and 24 hours from the beginning of NIV and at 12 and 24 hours after NIV was discontinued. A bench study was performed to assess the effects of positive end-expiratory pressure (PEEP), the fraction of inspired oxygen (F(I)O(2)), and air leaks on absolute humidity. We evaluated 3 HH settings: no HH, HH at the medium setting, and HH at the maximum setting. The temperature in the outlet chamber was 31 degrees C to 32 degrees C for the medium HH setting and 38 degrees C to 41 degrees C for the maximum HH setting.Results: In the clinical study, 12 patients were assigned to the Med group and 11 to the Max group. In the Med group, oral moistness decreased and NRS increased at 12 and 24 hours compared with 0 hours (P < .05). In the Max group, neither the oral moistness nor the NRS changed throughout the study period, whereas in the bench study, high F(I)O(2), high PEEP, and air leak decreased the absolute humidity for both HH settings (P < .01). However, it is not clear to what extent these factors affected the patients' oral dryness because the ranges of F(I)O(2) and PEEP were narrow.Conclusions: Oral dryness was a common problem in our patients. The HH setting significantly affected humidification and oral dryness during NIV. (c) 2011 Elsevier Inc. All rights reserved.