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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Impact of the humidification device on intubation rate during noninvasive ventilation with ICU ventilators: Results of a multicenter randomized controlled trial
Intensive Care Medicine, Volume 40, No. 2, Year 2014
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Description
Purpose: The use of heat and moisture exchangers (HME) during noninvasive ventilation (NIV) can increase the work of breathing, decrease alveolar ventilation, and deliver less humidity in comparison with heated humidifiers (HH). We tested the hypothesis that the use of HH during NIV with ICU ventilators for patients with acute respiratory failure would decrease the rate of intubation (primary endpoint) as compared with HME. Methods: We conducted a multicenter randomized controlled study in 15 centers. After stratification by center and type of respiratory failure (hypoxemic or hypercapnic), eligible patients were randomized to receive NIV with HH or HME. Results: Of the 247 patients included, 128 patients were allocated to the HME group and 119 to the HH group. Patients were comparable at baseline. The intubation rate was not significantly different: 29.7 % in the HME group and 36.9 % in the HH group (p = 0.28). PaCO2 did not significantly differ between the two arms, even in the subgroup of hypercapnic patients. No significant difference was observed for NIV duration, ICU and hospital LOS, or ICU mortality (HME 14.1 vs. HH 21.5 %, p = 0.18). Conclusions: In this study, the short-term physiological benefits of HH in comparison with HME during NIV with ICU ventilators were not observed, and no difference in intubation rate was found. The physiologic effects may have been obscured by leaks or other important factors in the clinical settings. This study does not support the recent recommendation favoring the use of HH during NIV with ICU ventilators. © 2013 Springer-Verlag Berlin Heidelberg and ESICM.
Authors & Co-Authors
Lellouche, François
France, Creteil
Hôpital Henri Mondor
Canada, Quebec
Institut Universitaire de Cardiologie et de Pneumologie de Québec - Université Laval
L'Her, Erwan
France, Brest
Hopital de la Cavale Blanche
Abrouk, Fekri
Tunisia, Monastir
Hospitalier Universitaire Fatouma Bourguiba
Deye, Nicolas
France, Paris
Hôpital Européen Georges-pompidou
Rodriguez, P. O.
France, Creteil
Hôpital Henri Mondor
Argentina, Buenos Aires
Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno
Rabbat, Antoine
France, Paris
Hôpital Hotel-dieu Ap-hp
Jaber, Samir
France, Montpellier
Hôpital Saint Eloi
Fartoukh, Muriel Sarah
France, Paris
Hôpital Tenon
Conti, Giorgio
Italy, Rome
Fondazione Policlinico Universitario Agostino Gemelli Irccs
Cracco, Christophe
France, Paris
Hôpital Universitaire Pitié Salpêtrière
Richard, Jean Christophe Marie
France, Rouen
Chu Rouen Normandie
Ricard, Jean Damien
France, Colombes
Hopital Louis-mourier
Mal, Hervé
France, Clichy
Hôpital Beaujon
Mentec, Hervé
France, Argenteuil
Centre Hospitalier Victor Dupouy D'argenteuil
Loisel, F.
Canada, Quebec
Chu de Québec-université Laval
Lacherade, J. C.
France, Poissy
Centre Hospitalier Intercommunal Poissy-st-germain-en-laye
Taillé, S.
France, Creteil
Hôpital Henri Mondor
Brochard, Laurent Jean
France, Creteil
Hôpital Henri Mondor
Statistics
Citations: 37
Authors: 18
Affiliations: 17
Identifiers
Doi:
10.1007/s00134-013-3145-z
ISSN:
03424642
e-ISSN:
14321238
Research Areas
Health System And Policy
Study Approach
Quantitative