Water content of delivered gases during non-invasive ventilation in healthy subjects
Water content of delivered gases during non-invasive ventilation in healthy subjects
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DOI：
10.1007/s00134-009-1455-y
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发表时间：
2009-06-01
影响因子：
38.9
通讯作者：
Brochard, Laurent
中科院分区：
文献类型：
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作者：
Lellouche, Francois;Maggiore, Salvatore Maurizio;Brochard, Laurent
关于无创通气 (NIV) 和高流量 CPAP 期间的加湿，目前尚无明确的建议，并且可用的湿度数据也很少。我们在 NIV 期间对使用不同加湿策略的健康受试者进行了湿度测量：加热加湿器 (HH)、热湿交换器 (HME) 或无加湿 (NoH)。对于每种策略，都使用具有不同 FiO(2) 设置的涡轮机和 ICU 呼吸机，有泄漏和无泄漏。在 CPAP 期间，测试了两种不同的 HH 和 NoH。测量吸入气体湿度并评估舒适度。在工作台上，我们还评估了环境空气温度、呼吸机温度和每分钟通气量对 HH 性能的影响（使用 NIV 设置）。在 NIV 期间，使用 NoH 时，使用 ICU 呼吸机时气体湿度非常低 (5 mgH(2)O/l)，但相当于使用涡轮呼吸机在最低 FiO(2) (13 mgH(2)O/l) 下测量的环境空气湿度。 HME 和 HH 具有相当的性能 (25-30 mgH(2)O/l)，但 HME 的有效性会因泄漏而降低 (15 mgH(2)O/l)。环境空气和通风机输出温度升高会降低 HH 性能。在 CPAP 期间，干燥气体 (5 mgH(2)O/l) 的耐受性低于加湿气体。加湿至 15 或 30 mgH(2)O/l 的气体具有同样的耐受性。本研究提供了 NIV 和 CPAP 期间采用不同加湿策略提供的湿度水平的数据。 HH 和 HME 提供含水量最高的气体。舒适度数据表明，高于 15 mgH(2)O/l 的水平具有良好的耐受性。在有利的条件下，即使存在泄漏，HH 和 HME 也能够提供此类值。
No clear recommendation exists concerning humidification during non-invasive ventilation (NIV) and high flow CPAP, and few hygrometric data are available.We measured hygrometry during NIV delivered to healthy subjects with different humidification strategies: heated humidifier (HH), heat and moisture exchanger, (HME) or no humidification (NoH). For each strategy, a turbine and an ICU ventilator were used with different FiO(2) settings, with and without leaks. During CPAP, two different HH and NoH were tested. Inspired gases hygrometry was measured, and comfort was assessed. On a bench, we also assessed the impact of ambient air temperature, ventilator temperature and minute ventilation on HH performances (with NIV settings).During NIV, with NoH, gas humidity was very low when an ICU ventilator was used (5 mgH(2)O/l), but equivalent to ambient air hygrometry with a turbine ventilator at minimal FiO(2) (13 mgH(2)O/l). HME and HH had comparable performances (25-30 mgH(2)O/l), but HME's effectiveness was reduced with leaks (15 mgH(2)O/l). HH performances were reduced by elevated ambient air and ventilator output temperatures. During CPAP, dry gases (5 mgH(2)O/l) were less tolerated than humidified gases. Gases humidified at 15 or 30 mgH(2)O/l were equally tolerated.This study provides data on the level of humidity delivered with different humidification strategies during NIV and CPAP. HH and HME provide gas with the highest water content. Comfort data suggest that levels above 15 mgH(2)O/l are well tolerated. In favorable conditions, HH and HMEs are capable of providing such values, even in the presence of leaks.