RT Book, Section
A1 Ricard, Jean-Damien
A1 Dreyfuss, Didier
A2 Tobin, Martin J.
SR Print(0)
ID 57078038
T1 Chapter 51. Humidification
T2 Principles and Practice of Mechanical Ventilation, 3e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-173626-8
LK accessanesthesiology.mhmedical.com/content.aspx?aid=57078038
RD 2024/04/24
AB Humidification  issues  are  overlooked  by  many  clinicians  in  the  intensive  care  unit  (ICU).  Because  the  need  to  heat  and  humidify  inspired  gases  during  mechanical  ventilation  is  unanimously  accepted,  this  process  is  considered  the  basic,  supportive  standard  of  care,  about  which  there  is  no  real  debate.  Yet,  considerable  controversy  has  surrounded  central  issues  concerning  humidification  such  as  the  level  of  adequate  humidification  and  how  to  provide  it,  the  influence  of  humidification  devices  on  the  incidence  of  ventilator-associated  pneumonia,  and  certain  patients  and  clinical  situations  and  their  requirements,  such  as  the  need  for  humidification  during  noninvasive  ventilation.  This  may  account  for  important  differences  in  the  practice  of  humidification  between  countries.1,2  Fortunately,  renewed  interest  has  emerged  over  the  past  decade,  as  indicated  by  several  clinical  studies  that  have  helped  settle  some  controversies.  This  chapter  will  review  the  reasons  for  conditioning  inspired  gases  by  recalling  the  normal  process  of  heating  and  humidifying  air  during  spontaneous  breathing,  the  physical  principles  of  humidification,  and  the  consequences  of  inappropriate  conditioning.  Devices  to  achieve  this  conditioning  are  covered  and  their  advantages  and  potential  drawbacks  discussed.  Finally,  practical  guidelines  are  provided.