insufficient humidification of respiratory gases in patients who are undergoing therapeutic hypothermia at a paediatric and adult intensive care unit

insufficient humidification of respiratory gases in patients who are undergoing therapeutic hypothermia at a paediatric and adult intensive care unit

;Yukari Tanaka;Sachiko Iwata;Masahiro Kinoshita;Kennosuke Tsuda;Shoichiro Tanaka;Naoko Hara;Ryota Shindou;Eimei Harada;Ryouji Kijima;Osamu Yamaga;Hitoe Ohkuma;Kazuo Ushijima;Teruo Sakamoto;Yushiro Yamashita;Osuke Iwata
religions 2017 Vol. 2017 pp. -
165
tanaka2017canadianinsufficient

Abstract

For cooled newborn infants, humidifier settings for normothermic condition provide excessive gas humidity because absolute humidity at saturation is temperature-dependent. To assess humidification of respiratory gases in patients who underwent moderate therapeutic hypothermia at a paediatric/adult intensive care unit, 6 patients were studied over 9 times. Three humidifier settings, 37-default (chamber-outlet, 37°C; Y-piece, 40°C), 33.5-theoretical (chamber-outlet, 33.5°C; Y-piece, 36.5°C), and 33.5-adjusted (optimised setting to achieve saturated vapour at 33.5°C using feedback from a thermohygrometer), were tested. Y-piece gas temperature/humidity and the incidence of high (>40.6 mg/L) and low (<32.9 mg/L) humidity relative to the target level (36.6 mg/L) were assessed. Y-piece gas humidity was 32.0 (26.8–37.3), 22.7 (16.9–28.6), and 36.9 (35.5–38.3) mg/L {mean (95% confidence interval)} for 37-default setting, 33.5-theoretical setting, and 33.5-adjusted setting, respectively. High humidity was observed in 1 patient with 37-default setting, whereas low humidity was seen in 5 patients with 37-default setting and 8 patients with 33.5-theoretical setting. With 33.5-adjusted setting, inadequate Y-piece humidity was not observed. Potential risks of the default humidifier setting for insufficient respiratory gas humidification were highlighted in patients cooled at a paediatric/adult intensive care unit. Y-piece gas conditions can be controlled to the theoretically optimal level by adjusting the setting guided by Y-piece gas temperature/humidity.

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199343
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10.1155/2017/8349874
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