Martin C, Thomachot L, Quinio B, Viviand X, Albanese J
Department of Anesthesia, Nord Hospital, Marseilles University Medical School, France.
Chest. 1995 May;107(5):1411-5. doi: 10.1378/chest.107.5.1411.
To evaluate in patients submitted to minute ventilation > 10 L/min the ability to preserve patients' heat and humidity of two heat and moisture exchangers (HMEs) and one vaporizing humidifier (VH).
Prospective, randomized, comparative, non-blinded study.
Intensive care unit of a university hospital.
Nine tracheally intubated, mechanically ventilated patients, sedated and submitted to mechanical ventilation with minute ventilation > 10 L/min.
Using the psychrometric method, relative humidity (RH) and absolute humidity (AH) of inspired gas were obtained as well as temperature of inspired gas and tracheal temperatures (maximal and minimal). Following a randomized order, each patient was ventilated for two 24-h periods with a vaporizing humidifier (Bennett Cascade 2, Bennett; France) and one of two HMEs: Pall Ultipor filter BB50 (Pall Biomedical; France) or DAR Hygroster filter (Peters; France). Both were first tested for a 45-min period and then the HME that achieved the best performance in terms of temperature and water preservation was tested for 24 h.
During the 45-min test period, the Pall Ultipor HME achieved a lower performance than the other two systems for any of the studied parameters (p < 0.05 to p < 0.0001). The DAR Hygroster HME achieved lower temperature of inspired gas (29.9 vs 32.0 degrees C, p < 0.005) and lower absolute humidity (29.3 vs 33.2 mg H2O/L, p < 0.005) than the Bennett Cascade 2. After 24 h of use, lower values of temperature of inspired gas (28.5 vs 32.0 degrees C, p < 0.002) and of AH (28.0 vs 33.6 mg H2O/L, p < 0.001) were obtained with the DAR Hygroster HME than with the Bennett Cascade 2. No differences were found between the two systems for the other tested parameters. At that time, no patients had RH lower than 97% and absolute humidity lower than 23 mg H2O/L with the use of the DAR Hygroster HME.
In patients with minute ventilation > 10 L/min, the DAR Hygroster HME showed a thermic and humidification capability similar to the reference system, the Bennett Cascade 2 VH. In these patients, the Pall Ultipor HME had a significantly lower capability.
评估分钟通气量>10L/min的患者使用两种热湿交换器（HME）和一种蒸发式加湿器（VH）时保持患者热量和湿度的能力。
前瞻性、随机、对照、非盲研究。
大学医院重症监护病房。
9例气管插管、机械通气患者，接受镇静，分钟通气量>10L/min。
采用湿度测定法获取吸入气体的相对湿度（RH）和绝对湿度（AH）以及吸入气体温度和气管温度（最高和最低）。按照随机顺序，每位患者分别使用蒸发式加湿器（贝内特Cascade 2，贝内特；法国）和两种HME之一进行两个24小时的通气：颇尔Ultipor过滤器BB50（颇尔生物医学；法国）或DAR Hygroster过滤器（彼得斯；法国）。两者均先进行45分钟的测试，然后对在温度和水分保持方面表现最佳的HME进行24小时测试。
在45分钟的测试期内，对于任何研究参数，颇尔Ultipor HME的性能均低于其他两个系统（p<0.05至p<0.0001）。DAR Hygroster HME的吸入气体温度（29.9对32.0摄氏度，p<0.005）和绝对湿度（29.3对33.2mg H2O/L，p<0.005）均低于贝内特Cascade 2。使用24小时后，DAR Hygroster HME的吸入气体温度（28.5对32.0摄氏度，p<0.002）和AH（28.0对33.6mg H2O/L，p<0.001）均低于贝内特Cascade 2。在其他测试参数方面，两个系统之间未发现差异。此时，使用DAR Hygroster HME时，没有患者的RH低于97%，绝对湿度低于23mg H2O/L。
在分钟通气量>10L/min的患者中，DAR Hygroster HME的加热和加湿能力与参考系统贝内特Cascade 2 VH相似。在这些患者中，颇尔Ultipor HME的能力明显较低。
