RT Journal Article
SR Electronic
T1 Short-Term Effects of Humidification Devices on Respiratory Pattern and Arterial Blood Gases During Noninvasive Ventilation
JF Respiratory Care
FD American Association for Respiratory Care
SP 1879
OP 1886
DO 10.4187/respcare.01278
VO 57
IS 11
A1 François Lellouche
A1 Claudia Pignataro
A1 Salvatore Maurizio Maggiore
A1 Emmanuelle Girou
A1 Nicolas Deye
A1 Solenne Taillé
A1 Marc Fischler
A1 Laurent Brochard
YR 2012
UL http://rc.rcjournal.com/content/57/11/1879.abstract
AB BACKGROUND: The impact of humidification devices on ventilatory and arterial blood gases parameters during noninvasive ventilation (NIV) remains controversial. The aim of the study was to compare the short-term impact of heat and moisture exchangers (HMEs) and heated humidifiers (HHs) during NIV for either hypercapnic or hypoxemic acute respiratory failure. METHODS: Consecutive subjects receiving NIV were successively treated with HME and HH in randomized order for 30 min each. At the end of each period, arterial blood gases were measured and ventilatory parameters were recorded. RESULTS: Eighty-one subjects were enrolled, of whom 52 were hypercapnic (with or without acidosis) and 29 hypoxemic. Minute ventilation was greater with the HME, in comparison with the HH (15 [12–18] vs 12 [10–16] median [interquartile range], P < .001), while PaCO2 was increased when using HME, indicating a dead space effect. This effect was observed in all subjects, but was more pronounced in hypercapnic subjects (PaCO2 62 ± 17 mm Hg with HME vs 57 ± 14 with HH, P < .001). In a subgroup of 19 subjects with respiratory acidosis, alveolar hypoventilation improved only with the HH. The amplitude of the dead space impact was a function of the degree of hypercapnia. CONCLUSIONS: Use of an HME decreased CO2 elimination during NIV, despite increased minute ventilation, especially in hypercapnic subjects.