Airway humidification in mechanically ventilated neonates and infants: a comparative study of a heat and moisture exchanger vs. a heated humidifier using a new fast-response capacitive humidity sensor.

OBJECTIVE: To study the efficiency of a heated humidifier and a heat and moisture exchanger in mechanically ventilated neonates and infants.

DESIGN: Prospective, controlled, clinical study.

SETTING: University pediatric intensive care unit.

PATIENTS: Forty neonates and infants who needed mechanical ventilation were enrolled in the study.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: A heat and moisture exchanger and active airway humidification were alternately used in the same patients to exclude interindividual differences in airway humidification. Airway humidity was measured by a new fast-response capacitive humidity sensor which measures airway humidity with an acquisition rate of 20 Hz throughout the respiratory cycle. The humidity sensor was placed at the endotracheal tube adapter. Measurements were done at the beginning and at the end of three consecutive sessions of passive, active, and again passive airway humidification, each session lasting 6 hrs. There was no significant difference between mean inspiratory airway humidity with the heated humidifier (33.8 +/- 2.9 mg/L) and with the heat and moisture exchanger (34.0 +/- 2.6 mg/L). Moreover, the mode of airway humidification did not significantly influence body temperature or PCO2. No serious side effects such as endotracheal tube occlusion were observed.

CONCLUSIONS: Passive airway humidification by a heat and moisture exchanger is effective in mechanically ventilated neonates and infants over a 6-hr period. However, the performance and safety of a heat and moisture exchanger in prolonged mechanical ventilation remain to be proven.