TY - JOUR T1 - Heated humidification improves clinical outcomes compared to a heat-and-moisture exchanger in children with tracheostomies JF - Respiratory Care DO - 10.4187/respcare.02214 SP - respcare.02214 AU - David G McNamara AU - M. Innes Asher AU - Bruce K Rubin AU - Alistair Stewart AU - Catherine A Byrnes Y1 - 2013/06/12 UR - http://rc.rcjournal.com/content/early/2013/06/13/respcare.02214.abstract N2 - Background: The upper airway humidifies and warms inspired gases before they reach the trachea, a process bypassed by the insertion of a tracheostomy, necessitating humidification of inspired gases. The optimal method of humidification is not known. Methods: We conducted a short term 20-hour and a long term 10-week randomised cross-over studies comparing a heated humidifier (HH) to a heat-and-moisture exchanger (HME) in children with established tracheostomies. Participants were assessed for clinical events, clinical examination findings, airway cytokine levels and airway secretion viscoelasticity. Results: Fifteen and 14 children were recruited to the short and long term studies respectively. Children wearing the HH had decreased respiratory examination score (p < 0.001) and improved oxygenation (p=0.012) but no change in clinical events over the short-term. There was a decrease in acute clinical events (p=0.008) in the long term study. No differences were found in airway secretion viscoelasticity results or cytokine levels in either study, but these sample numbers were limited. Conclusion: Over 20 hours use of HH compared to HME improved work of breathing. Over a longer 10 week treatment period HH resulted in decreased adverse clinical events. ER -