A change in humidification system can eliminate endotracheal tube occlusion

• Published in: Journal of critical care Vol. 26; no. 6; pp. 637.e1 - 637.e4
• Main Authors: Doyle, Alex, MBBS, Joshi, Manasi, MBBS, Frank, Peter, MB, BChir, Craven, Thomas, MB, BChir, Moondi, Parvez, MB, ChB, Young, Peter, MB, ChB, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2011; Elsevier Limited
• Subjects: Aged; Bronchoscopy; Complications; Critical Care; England; Female; Humans; Humidity; Incidence; Intensive Care Units; Intubation; Intubation, Intratracheal - instrumentation; Male; Mechanical ventilation; Middle Aged; Net losses; Patients; Physiology; Pneumonia, Ventilator-Associated - prevention & control; Prospective Studies; Statistical analysis; Treatment Outcome; England; United Kingdom > UK; Complications; Mechanical ventilation; Intubation
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2011.02.004

Abstract Purpose Inadequate airway humidification can result in endotracheal tube occlusion. There is evidence that heat and moisture exchangers (HMEs) are more prone to endotracheal tube occlusion than heated humidifiers (HHs) that contain a heated wire circuit. We aimed to compare the incidence of endotracheal tube occlusion while introducing a new dual-heated wire circuit HH in place of an established hydrophobic HME. Materials and Methods This was a prospective observational study. All patients who required intubation were included in our analysis. Univariate statistical analysis was performed using a Fisher exact test. P < .05 was considered statistically significant. Results There were 158 patients in the HME group and 88 patients in the HH group. The incidence of endotracheal tube occlusion was 5.7% in the HME group and 0% in the HH group. Statistical analysis revealed a significant difference between the 2 groups ( P = .02). In light of this finding, we changed our practice to provide humidification exclusively by HH. In the subsequent 18-month period, there were no further episodes of endotracheal tube occlusion. Conclusions Our study demonstrates that there is a significant increase in the incidence of endotracheal tube occlusion when using a hydrophobic HME compared with an HH and that using a dual-heated wire circuit HH can eliminate endotracheal tube occlusion.