Humidification: current therapy and controversy
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
1998
|
| Series: | Respiratory care clinics of North America
4,2 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XV S., S. 189 - 344 Ill., graph. Darst. |
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Record in the Search Index
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| adam_text | HUMIDIFICATION
CONTENTS
Foreword xi
RICHARD D. BRANSON and NEIL R. MacINTYRE
Preface xiii
RICHARD D. BRANSON, BRYAN D. PETERSON, and KEVIN D. CARSON
Normal Mechanisms of Heat and Moisture Exchange in the
Upper Respiratory Tract 189
DENNIS IRLBECK
The initial conditioning of the inhaled gases occurs in the upper
respiratory tract. The conditioned gases are at approximately 32°C
and more than 95% relative humidity as they enter the lower
respiratory tract. This level of heat and humidity will preserve the
body s defense mechanisms. When the upper airway is bypassed the
gases being delivered to the lower airways need to be as close to
physiologic levels as possible based on the length of time the
endotracheal tube will be in place. The delivery of gases above or
below normal physiologic levels has been shown to produce clinical
problems.
The Effects of Inadequate Humidity 199
RICHARD D. BRANSON
The effects of inadequate humidity on the respiratory tract have
been well described over the past 40 years. These effects include
histopathologic changes, alterations in respiratory mechanics,
inspissation of secretions, and ciliary dysfunction. This article
reviews the literature concerning the effects of inadequate humidity
with particular reference to both gas temperature and relative
humidity. Much of the current information upon which minimum
humidity standards are based originate in this literature. In many
cases, this data is the result of short term studies during anesthesia
or short term studies in animal models. The appropriateness of
applying these results to human subjects with respiratory disease
requiring days of ventilatory support is discussed.
RESPIRATORY CARE CLJNCS OF NORTH AMERICA 4:2. June 1998
V
The Effects of Excessive Humidity 215
ROBIN B. WILLIAMS
Ventilator gases must be heated and humidified for the intubated
patient. Humidification devices can produce water vapor or aerosols
at a wide range of gas temperatures, some of which are excessive
and can lead to airway injury. This article discusses the potential
for injury in terms of the separate water volume and heat energy
challenges, reviews the reported effects of these excesses, and offers
an opinion on the upper limits of safe humidification.
Measuring Temperature and Humidity in the Breathing Circuit 229
PAUL J. SEAKINS
Accurate measurement of temperature and humidity in the
breathing circuit can be a difficult task. This article introduces basic
humidity concepts, outlines the problems that are unique to the
breathing circuit, and describes the various methods that are
available to measure temperature and humidity. Recommendations
are made on how to measure temperature and humidity in four
commonly encountered situations.
Heated Humidifiers: Structure and Function 243
BRYAN D. PETERSON
Heated humidifiers are available from many different manufacturers.
The generic humidifier types are discussed, as are the mechanisms
by which they work. Typical usage and setting of heated
humidifiers in various applications are also mentioned. Essentially,
heated humidifiers have no contraindications and can be used
successfully on any patient requiring ventilatory assistance or
supplemental oxygen. Heated humidifiers can be set to deliver
practically any level of humidity, most importantly gas heated to
body temperature and saturated with water vapor.
Heat and Moisture Exchangers: Structure and Function 261
ANTONY R. WILKES
Heat and moisture exchangers (HMEs) are intended to be used to
increase the moisture content of the gas delivered to the respiratory
tract of patients during anesthesia and intensive care. HMEs
incorporating a breathing system filter (BSF) are additionally
intended to isolate the patient microbially from the breathing
system. The moisture conserving performance of HMEs depends on
the ventilatory parameters, the expired gas temperature, humidity in
the breathing system, and ambient temperature; resistance to gas
flow, internal volume, compliance, size, shape, and transparency of
the casing, in addition to cost, are also features to consider when
choosing between different devices. This article describes the
structure and function of HMEs and BSFs, and how they are tested.
Hazards associated with their use are also described.
vi
Humidification During Anesthesia 281
KEVIN D. CARSON
Humidification during anesthesia is important to prevent adverse
changes in the upper airways and possible pulmonary compromise.
These changes may take place in less than one hour using dry
nonhumidified anesthetic gases. Consequently, some method of
humidification should be employed for all but the shortest of
surgical procedures requiring general anesthesia. Methods of
humidification include the anesthesia breathing system itself,
passive humidification or conservation of moisture, and active
humidification. Humidification for neonatal and pediatric patients
requires special consideration of resistance, work of breathing, and
dead space. Further work is necessary with regard to the use of
HMEs in this population of patients undergoing general anesthesia.
Humidification Practices in the Adult Intensive Care Unit,
Prince of Wales Hospital 301
JOHN C. LAWRENCE
In the Adult Intensive Care Unit of The Prince of Wales Hospital,
Sydney, Australia, inspiratory gas is humidified to saturation at
37°C. This stops the buildup of dried sputum within the
endotracheal tubes and thus prevents blocked tubes and the
increased resistance caused by partial obstruction. Inspiratory and
expiratory hose heater wires are used to produce a completely dry
circuit, allowing the elimination of water traps and circuit support
arms without the resistance of a heat and moisture exchanger.
Humidification in the Intensive Care Unit 305
RICHARD D. BRANSON and ROBERT S. CAMPBELL
Conditioning inspired gases is necessary for the safe application of
mechanical ventilation via a translaryngeal tube. There is little
disagreement concerning the need to heat and humidify inspired
gases. The methods to accomplish heat and humidification and the
appropriate temperature and humidity are less well defined. The
required humidity changes with patient lung health, patient
temperature, duration of ventilatory support, and the goal of
therapy. With this concept in mind, the authors have developed an
algorithm for providing humidity based on these variables. Both
passive and active humidifiers are necessary to meet the needs of
the wide variety of patients seen in the intensive care unit. By
matching humidification device to patient need, humidification is
delivered in the most efficacious and cost effective manner. When
properly cared for, humidification devices play no role in the
pathogenesis of nosocomial pneumonia. Rewarming the patient via
the respiratory tract, however, is ill advised.
What is Optimum Humidity? 321
NIGEL RANKIN
The relevant aspects of the normal physiology of the airway mucosa
and the customary ways of describing humidity are briefly
vii
reviewed. The need for surrogate markers of optimum humidity is
identified, and two such markers are proposed. The relationship
between the humidity of the inspired gas and mucosal function is
examined using a model that is then validated. Optimum humidity
is achieved when the inspired gas is at body core temperature and
100% relative humidity.
The Role of Filtration During Humidification 329
GLENN RICHARDS
Current evidence suggests that circuit contamination is usually a
result rather than a cause of airway colonization and does not have
an important role in the pathogenesis of nosocomial pneumonia.
Provided that reasonable infection control measures are taken,
circuit contamination does not pose a risk to the ventilated patient.
Although bacterial filters placed in the circuit effectively prevent
circuit contamination they do not significantly reduce the incidence
of nosocomial pneumonia in patients receiving mechanical
ventilation.
Index 341
Subscription Information Inside back cover
viii
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| physical | XV S., S. 189 - 344 Ill., graph. Darst. |
| publishDate | 1998 |
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| series | Respiratory care clinics of North America |
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| spelling | Humidification current therapy and controversy Richard D. Branson, ... guest ed. Philadelphia [u.a.] Saunders 1998 XV S., S. 189 - 344 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Respiratory care clinics of North America 4,2 Humidité - Physiologie Humidity Physiological effects Künstliche Beatmung (DE-588)4033439-9 gnd rswk-swf Luftbefeuchtung (DE-588)4168228-2 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Künstliche Beatmung (DE-588)4033439-9 s Luftbefeuchtung (DE-588)4168228-2 s DE-604 Branson, Richard D. Sonstige oth Respiratory care clinics of North America 4,2 (DE-604)BV010811241 4,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008172585&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Humidification current therapy and controversy Respiratory care clinics of North America Humidité - Physiologie Humidity Physiological effects Künstliche Beatmung (DE-588)4033439-9 gnd Luftbefeuchtung (DE-588)4168228-2 gnd |
| subject_GND | (DE-588)4033439-9 (DE-588)4168228-2 (DE-588)4143413-4 |
| title | Humidification current therapy and controversy |
| title_auth | Humidification current therapy and controversy |
| title_exact_search | Humidification current therapy and controversy |
| title_full | Humidification current therapy and controversy Richard D. Branson, ... guest ed. |
| title_fullStr | Humidification current therapy and controversy Richard D. Branson, ... guest ed. |
| title_full_unstemmed | Humidification current therapy and controversy Richard D. Branson, ... guest ed. |
| title_short | Humidification |
| title_sort | humidification current therapy and controversy |
| title_sub | current therapy and controversy |
| topic | Humidité - Physiologie Humidity Physiological effects Künstliche Beatmung (DE-588)4033439-9 gnd Luftbefeuchtung (DE-588)4168228-2 gnd |
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