[A trial comparing artificial noses and heat exchangers during assisted ventilation using tracheotomy at home. CARDIF. The Committee of the Organization of Respiratory Assistance of the Ile-de-France].

Thirteen patients with a tracheostomy who were undergoing artificial ventilation at home were included in a study covering 62 episodes, during a month of treatment, which was undertaken with three different humidification systems: A Puritan Bennet Cascade humidifier (C), a Swedish nose Vygon-(V) (a hydroscopic condenser humidifier) and a Pall filter (P). Five patients abandoned the study because of discomfort with C (1), P (2), or V (2). The discomfort described by three patients was identical with the three systems used during ventilation. The two systems using the artificial heat humidification exchanger were considered more simple to use than the Cascade for the patients. Using the system for three years for a patient who was being ventilated for 12 hours out of 24 showed the increasing cost ranging from the Vygon nose, to the Cascade and finally to the Pall filter. The percentage of time spent on antibiotics was identical with the three systems (11% of the time). A bacteriological study showed that only the Pall filter permitted the respirator tubes to be kept sterile. The most polluted circuit from the bacteriological point of view was that used with the Cascade. In conclusion, when it was compared to the humidifier Cascade the two artificial noses appeared as simple to use and the Pall filter was the safest bacteriologically.