%0 Journal Article %A David G McNamara %A M Innes Asher %A Bruce K Rubin %A Alistair Stewart %A Catherine A Byrnes %T Heated Humidification Improves Clinical Outcomes, Compared to a Heat and Moisture Exchanger in Children With Tracheostomies %D 2014 %R 10.4187/respcare.02214 %J Respiratory Care %P 46-53 %V 59 %N 1 %X 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 study and a long-term 10-week randomized crossover study comparing a heated humidifier (HH) to a heat and moisture exchanger (HME) in children with established tracheostomies. Subjects were assessed for clinical events, clinical examination findings, airway cytokine levels, and airway secretion viscoelasticity. RESULTS: For the short-term study, 15 children were recruited; for the long-term study, 14 children were recruited. Children using the HH had decreased respiratory examination score (P < .001) but no change in clinical events over the short term. There was a decrease in acute clinical events (P = .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. CONCLUSIONS: Over 20 hours use, HH, compared to HME, improved work of breathing. Over a longer 10 week treatment period HH resulted in decreased adverse clinical events. %U https://rc.rcjournal.com/content/respcare/59/1/46.full.pdf