Inspired gas temperature in ventilated neonates.

The warming and humidification of inspired gases for ventilated neonates are routine. There are no data on the temperature of the gas at the airway opening in ventilated neonates. Is the inspired gas temperature at the airway opening, as expected and set on the humidifier, around 37 degrees C? We aimed to measure temperature at the airway opening and compare this with the circuit temperature. This was an observational study in a neonatal intensive care unit. Twenty-five mechanically ventilated infants were studied. All had humidifiers with chamber temperature set at 36 degrees C and the circuit temperature set at 37 degrees C. Two temperature probes were inserted and rested at the circuit-exit and at the airway opening, and temperatures were measured for 2 min in each infant. At this time, the circuit temperature was also noted. The mean (SD) temperature at the airway opening in infants nursed in incubators was 34.9 (1.2) degrees C, compared with radiant warmers where the mean (SD) was 33.1 (0.5) degrees C. The mean (SD) difference in temperature from the circuit temperature probe to the airway opening was greater under radiant warmers, with a mean (SD) drop of 3.9 (0.6) degrees C compared with a mean (SD) drop of 2.0 (1.3) degrees C in the incubators. In conclusion, the temperature at the circuit temperature probe does not reflect the temperature at the airway opening. Inspired gas temperatures are lower than the expected 37 degrees C with the normal circuits and usual humidifier settings.