The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

A RANDOMIZED CONTROLLED TRIAL COMPARING AN EXTENDED USE HYGROSCOPIC CONDENSER HUMIDIFIER (HCH) TO HEATED HUMIDIFICATION (HH) IN MECHANICALLY VENTILATED PATIENTS

Marin H. Kollef, MD; M. Dametta Clinkscale, RRT; Vanessa Boyd, RRT; Patricia Silver MEd; Ellen Trovillion, BSN, Pulmonary and Critical Care Division, Washington University School of Medicine, St. Louis, MO

Background: To compare a 7-day HCH (HMEE, Nellcor Puritan Bennett) to HH (MR730 Respiratory Humidifier, Fisher & Paykel Healthcare, New Zealand) using a heated wire ventilator circuit. Method: Randomized controlled trial of HH vs HCH in a medical-surgical ICU. Patients with asthma, cystic fibrosis, and purulent bronchiectasis were excluded. Cross over from HCH to HH was allowed when copious secretions caused plugging of the HCH. Results: One hundred fifteen surgical and 82 medical patients requiring mechanical ventilation were randomized. Five of 96 (5.2%) patients in the HCH group crossed over to the HH group due to copious secretions. Eighteen (18.8%) HCH patients required mechanical ventilation for greater than 7 days.

HCH HH*

(n=96) (n=101)

Age, yr: 58.3 ± 16.8 57.9 ± 17.0

APACHE II: 17.2 ± 7.0 17.8 ± 6.4

MV, days: 4.5 ± 5.5 3.7 ± 4.2

ETT occlusions, No.(%): 0 (0.0) 0 (0.0)

Humidification Costs@,$: 1064 3209

Death, No.(%): 21 (22.1) 25 (24.7)

VAP, No.(%): 9 (9.4) 11 (10.9)

(APACHE = Acute Physiology and Chronic Health Evaluation; MV = mechanical ventilation; VAP = ventilator-associated pneumonia; ETT = endotracheal tube); *P > 0.1 all comparisons.

@ Costs include the costs of changing HCHs due to soilage and crossing over to HH in the HCH group.

Conclusions: These data suggest that an extended use HCH may be a safe and cost-effective method of providing humidification to patients requiring mechanical ventilation.

OF-97-005

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