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.
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.