To compare the degree of bacterial circuit colonization, frequency of ventilator-associated pneumonia (VAP), character of respiratory secretions, rewarming of hypothermic patients, disposable costs, and air flow resistance in intensive care patients ventilated using either a heat and moisture exchanger (HME) or hot water (HW) humidifier circuit.
A prospective, randomized blinded trial of patients in the intensive care unit undergoing mechanical ventilation.
A metropolitan teaching hospital.
One hundred sixteen patients undergoing mechanical ventilation for a minimum period of 48 hrs were enrolled.
Patients were randomized to three ventilation groups using a) an HW circuit with a 2-day circuit change (n=41) ; or b) a bacterial-viral filtering HME in the circuit, with either a 2-day (n=42) ; or c) a 4-day circuit change (n=33).
Circuit colonization was assessed using quantitative culture of washings taken from the circuit tubing and semiquantitative culture of swabs from the Y connectors.
Sixty-seven percent of HW circuits became contaminated compared with 12% in the two HME groups (p<. 0001).
Median colony counts were lower in the HME groups (p<. 0001).
If circuits at first circuit change were contaminated in the HW group, 89% of subsequent circuit changes became contaminated compared with 0% and 25% for the 2-and 4-day HME groups, respectively. (...)
Mots-clés Pascal : Ventilation mécanique, Ventilateur, Filtre, Echangeur chaleur, Humidité, Etude comparative, Evaluation performance, Appareillage, Homme, Analyse coût, Economie santé, Ventilation artificielle, Soin intensif
Mots-clés Pascal anglais : Mechanical ventilation, Fan, Filter, Heat exchanger, Humidity, Comparative study, Performance evaluation, Instrumentation, Human, Cost analysis, Health economy, Artificial ventilation, Intensive care
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0542582
Code Inist : 002B27B14D. Création : 24/03/1998.