Vitacca M, Clini E, Foglio K, Scalvini S, Marangoni S, Quadri A, Ambrosino N
Division of Pneumology, Clinica del Lavoro Foundation IRCCS, Medical Center of Rehabilitation, Gussago, Italy.
Eur Respir J. 1994 Nov;7(11):2026-32.
The aim of this study was to test the usefulness of hygroscopic condenser humidifiers on secretion and on inspired gas temperature in tracheostomized patients. Forty spontaneously breathing chronically tracheostomized patients were divided into two groups: Group 1 received a hygroscopic condenser humidifier connected to the tracheostomy, 24 h daily for 10 days; Group 2, without any protection system, was chosen as the control group. The daily number of tracheal suctions, quantity of aspirate and thickness and colouring of secretions was evaluated. At baseline, and at days 5 and 10, patients were submitted to blood gas analysis, respiratory function tests and sputum analysis. The temperature of gases breathed was measured at rest and during a hyperventilation test, with and without the hygroscopic condenser humidifier. Statistically significant differences were found in thickness and colouring of secretions between the two groups during the period of 10 days. Group 2 showed a significantly greater trend in number of bacteria than Group 1. The group with the hygroscopic condenser humidifier showed respiratory function improvement over time for forced expiratory volume in one second (FEV1) and tidal volume (VT), maximal inspiratory pressure (MIP), and maximal voluntary ventilation (MVV) in comparison to the control group, who did not. Significant differences in the temperature between rest and hyperventilation, with and without a hygroscopic condenser humidifier were also found. In conclusion, a hygroscopic condenser humidifier may be useful in chronically tracheostomized patients who breathe spontaneously, improving viscosity and colouring of secretions, preventing further bacterial colonization, heating inspiratory flow, and helping to improve the functional outcome.
本研究的目的是测试吸湿冷凝式加湿器对气管切开患者分泌物及吸入气体温度的作用。40例慢性气管切开的自主呼吸患者被分为两组：第1组患者每天24小时使用连接在气管造口处的吸湿冷凝式加湿器，持续10天；第2组未使用任何保护系统，作为对照组。评估每日气管抽吸次数、吸出物量以及分泌物的厚度和颜色。在基线、第5天和第10天，对患者进行血气分析、呼吸功能测试和痰液分析。在静息状态和过度通气试验期间，分别测量使用和不使用吸湿冷凝式加湿器时吸入气体的温度。在10天的观察期内，两组患者分泌物的厚度和颜色存在统计学显著差异。第2组的细菌数量增长趋势明显高于第1组。与未使用吸湿冷凝式加湿器的对照组相比，使用该加湿器的组在1秒用力呼气容积（FEV1）、潮气量（VT）、最大吸气压力（MIP）和最大自主通气量（MVV）方面，呼吸功能随时间有所改善。同时，在使用和不使用吸湿冷凝式加湿器的情况下，静息和过度通气时的温度也存在显著差异。总之，吸湿冷凝式加湿器对于慢性气管切开的自主呼吸患者可能是有用的，它可改善分泌物的黏稠度和颜色，防止细菌进一步定植，加热吸入气流，并有助于改善功能预后。
