2004 OPEN FORUM Abstracts
THE EFFECT OF RADIANT WARMER/ISOLETTE HEATERS ON HUMIDIFIER TEMPERATURE AND TEMPERATURE PROBE.
Stephen G. Staib RRT. Hahnemann University Hospital, Neonatal Intensive
Background: It has been stated that there is an adverse effect on the humidifier temperature when the temperature probe is placed within the radiant warmer bed or placed inside an isolette. This was a bench study devised to test that statement. Objective: To determine if there is any change in patient skin temperature, humidifier temperature, and humidifier chamber temperature when the temperature probe is placed in the center of the radiant warmer and when placed inside the isolette. Materials: Bird VIP ventilator with neonatal ventilator tubing, Fisher-Paykel MR730 humidifier with temperature probe and continuous water feed chamber, Airshields IICS90 radiant warmer with skin probe, Airshields isolette infant incubator C100, Sensormedics 3100A high frequency oscillator, and a 50cc anesthesia bag to simulate a patient.
Methods: In a room chosen to maintain the same environment for the study, the equipment was set up to mimic a patient on a neonatal ventilator and oscillator. The ventilator was set up so that the temperature probe was centered on the warmer bed and isolette. The warmer and isolette was set up to provide a skin temperature of at least 36ºC with the skin probe attached to the anesthesia bag. The VIP was set as follows; SIMV, f=20bpm, Ti .35seconds, flow 10 Lpm, peak pressure 20cm, positive end expiratory pressure 5cm, FIO2 1.0, and the humidifier were set at 36ºC. The ventilators were set at the top of the warmer (not the side) and allowed to run for 8 hours a day for 7 days. Measurements of skin temperature, humidifier temperature, and chamber temperature every 30 min and recorded. One 8-h day was used to incorporate plastic wrap that is used to maintain the body temperature of the infants (stretched form the side partitions of the warmer). One 8-hour test day was used to determine the effects of a temperature probe attached to the high frequency oscillator Ventilator (HFOV) with the settings of Ti% 33, HZ 15.0, ? p 15.0cm, power 2.0, map 12cm, and bias flow at 20Lpm (these settings were based on a patient currently on HFOV.)
Results: Warmer temperature ranged from 35.5º-36.5ºC in all ventilator and oscillator test days. Humidifier temperature ranged from 35.8º-36.8º C on all test days. Chamber temperature ranged from 34.0º-36.1ºC in all ventilator test days and 33.9º-34.7ºC.
Conclusion: 1) There was no significant effect on the temperature of the humidifier by either the radiant warmer or the isolette. 2) This shows that the temperature probe can be placed anywhere near the patient and the humidifier will adjust the chamber temperature to provide the set temperature. 3) The position of the temperature probe can be positioned anywhere in the warmer or isolette to allow proper nursing care. 4) While the study was going on, there were other patients in the NICU on the same neonatal ventilator and oscillator that was observed to have significant rainout compared to the study ventilators. (The temperature probes of these ventilators were located outside the radiant warmers and isolettes) Example; there was 300cc’s of condensation drained from the oscillator patient (measured by syringe) during the same eight-hour period the HFOV study was going on which yielded 30cc of condensation.