Ricard J D, Markowicz P, Djedaini K, Mier L, Coste F, Dreyfuss D
Service de Réanimation Médicale, Hôpital Louis Mourier (Assistance Publique-Hopitaux de Paris), Colombes, France.
Chest. 1999 Jun;115(6):1646-52. doi: 10.1378/chest.115.6.1646.
To determine the correlation between simple rating of condensation seen in the flex-tube connecting the heating and humidifying device used with the endotracheal tube and hygrometric parameters (absolute and relative humidity and tracheal temperature) measured by psychrometry.
Prospective randomized clinical trial.
Medical ICU of Louis Mourier Hospital, Colombes, France, a university-affiliated teaching hospital.
Forty-five consecutive mechanically ventilated critically ill patients.
Patients undergoing mechanical ventilation were randomly assigned to receive humidification with one of the four heat and moisture exchangers (HMEs) tested or with a conventional heated humidifier.
The hygrometric performances of four HMEs (BB2215, BB50, and BB100 from Pall Biomedical, Saint-Germaine-en-Laye, France; and Hygrobac-Dar from Mallinckrodt, Mirandola, Italy) and a heated humidifier (Fisher & Paykel; Auckland, New Zealand) were studied after 3 h and also after 48 h of use for the Hygrobac-Dar and correlated to a clinical visual inspection rating the amount of condensation in the flex-tube of the endotracheal tube.
A total of 95 measurements in 45 patients were performed. The best hygrometric parameters were obtained with the heated humidifier (p < 0.001). The Hygrobac-Dar yielded significantly higher values for both humidities and tracheal temperature than the other three HMEs (p < 0.001). The performance of Hygrobac-Dar was unchanged after 48 h of use. There was a significant correlation between the condensation seen in the flex-tube and the hygrometric parameters measured by psychrometry (absolute humidity, rho = 0.7; relative humidity, rho = 0.7; tracheal temperature, rho = 0.5, p < 0.0001).
In mechanically ventilated ICU patients, visual evaluation of the condensation in the flex-tube provides an estimation of the heating and humidifying efficacy of the heating and humidifying device used, thus allowing the clinician bedside monitoring of airway humidification.
确定在与气管内导管配套使用的加热湿化装置的挠性管中所见到的冷凝物简单分级与通过干湿球湿度计测量的湿度参数（绝对湿度、相对湿度和气管温度）之间的相关性。
前瞻性随机临床试验。
法国哥伦布市路易·穆里耶医院的医学重症监护病房，一所大学附属教学医院。
45例连续接受机械通气的重症患者。
接受机械通气的患者被随机分配使用四种经测试的热湿交换器（HME）之一或传统加热湿化器进行湿化。
在使用3小时后以及使用48小时后（仅针对Hygrobac-Dar）研究了四种HME（法国圣日耳曼昂莱的颇尔生物医学公司生产的BB2215、BB50和BB100；以及意大利米兰多拉的马林克罗德特公司生产的Hygrobac-Dar）和一种加热湿化器（新西兰奥克兰的费雪派克公司生产）的湿度性能，并将其与对气管内导管挠性管中冷凝物量进行临床目视检查的评级相关联。
对45例患者共进行了95次测量。加热湿化器获得了最佳的湿度参数（p<0.001）。Hygrobac-Dar在湿度和气管温度方面产生的值均显著高于其他三种HME（p<0.001）。使用48小时后，Hygrobac-Dar的性能未发生变化。挠性管中见到的冷凝物与通过干湿球湿度计测量的湿度参数（绝对湿度，rho = 0.7；相对湿度，rho = 0.7；气管温度，rho = 0.5，p<0.0001）之间存在显著相关性。
在机械通气的重症监护病房患者中，对挠性管中冷凝物的目视评估可提供对所使用的加热湿化装置的加热和湿化效果的估计，从而使临床医生能够在床边监测气道湿化情况。
