Christiansen S, Renzing K, Hirche H, Reidemeister J C
Abteilung für Thorax- und Kardiovaskuläre Chirurgie, Universität Essen.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1998 May;33(5):300-5. doi: 10.1055/s-2007-994253.
Humidification of inspired gas in artificially ventilated patients positively influences mucociliary function and secretolysis. We performed this study to examine the properties of heat and moisture exchangers in comparison with hot water humidifiers and dry artificial ventilation.
We measured inspired humidity with a special sensor in 41 patients after coronary artery bypass grafting with cardiopulmonary bypass. Three Heat and Moisture Exchangers (HME) and a hot water humidifier were used to humidity the inspired gas of artificially ventilated patients. Humidity measurements were compared.
Hot water humidifiers produced the highest humidification (average of 38.4 mg/l, 37-43 mg/l); lowest humidification was produced by dry artificial ventilation (average of 8.7 mg/l, 6-11 mg/l). Heat and moisture exchangers (HME) produced humidity between 24 and 36 mg/l. Highest humidification was produced by HME hygrobac s (average of 32.2 mg/l, 31-36 mg/l) and hygrovent s (average of 31.4 mg/l, 29-35 mg/l); lowest humidification was produced by HME hygroster (average of 28.6 mg/l, 24-31 mg/l). Multifactorial analysis shows a significant impact of the humidification method on the humidity of inspired gas. The multiple comparison procedure (Tukey) shows significant differences (alpha = 0.05) between all humidification techniques on inspired gas except the heat and moisture exchangers hygrobac s and hygrovent s.
Hygrobac s and hygrovent s may be an alternative to hot water humidifiers. Further clinical studies of HMEs and hot water humidifiers will be necessary to evaluate the influence of inspired gas humidity on the outcome of artificially ventilated patients.
人工通气患者吸入气体的湿化对黏液纤毛功能和分泌物溶解有积极影响。我们开展本研究以比较热湿交换器与热水加湿器及干式人工通气的特性。
我们使用特殊传感器对41例接受体外循环冠状动脉搭桥术的患者的吸入湿度进行了测量。使用三个热湿交换器（HME）和一个热水加湿器对人工通气患者的吸入气体进行湿化。对湿度测量结果进行了比较。
热水加湿器产生的湿化效果最佳（平均为38.4毫克/升，范围37 - 43毫克/升）；干式人工通气产生的湿化效果最差（平均为8.7毫克/升，范围6 - 11毫克/升）。热湿交换器（HME）产生的湿度在24至36毫克/升之间。HME hygrobac s产生的湿化效果最佳（平均为32.2毫克/升，范围31 - 36毫克/升），hygrovent s次之（平均为31.4毫克/升，范围29 - 35毫克/升）；HME hygroster产生的湿化效果最差（平均为28.6毫克/升，范围24 - 31毫克/升）。多因素分析表明湿化方法对吸入气体湿度有显著影响。多重比较程序（Tukey）显示，除热湿交换器hygrobac s和hygrovent s外，所有湿化技术在吸入气体方面均存在显著差异（α = 0.05）。
Hygrobac s和hygrovent s可能是热水加湿器的替代产品。有必要对热湿交换器和热水加湿器开展进一步的临床研究，以评估吸入气体湿度对人工通气患者预后的影响。
