Is humidification necessary?

efccna.org

Is humidification necessary?

Is moist

necessary

Heléne Karlman Tiina Rintala

EfCCNa March 2011


NICU Karolinska University

Hospital Stockholm

Här ska vi ha en bild på niva

Heléne Karlman Tiina Rintala

EfCCNa March 2011


NICU Karolinska University

Hospital Stockholm

‣ 9 beds including 1 isolation room

‣ Mainly patients with neurosurgical, neurological

and infection diagnosis admitted

‣ 469 admittances 2010

‣ 82 nursing staff working on 24 hour rotation

Heléne Karlman Tiina Rintala

EfCCNa March 2011


Aim

‣ Investigate and evaluate the effects of heated

humidification on patients admitted to

Neurointensive Care unit in need of invasive

mechanical ventilation.

Heléne Karlman Tiina Rintala

EfCCNa March 2011


Hypothesis

‣ Humidified heated ventilation:

- reduces duration of invasive mechanical ventilation.

- reduces NICU length of stay.

- reduces ventilator associated pneumonia (VAP).

- reduces airway secretion.

- reduces interventions to improve lungfunction.

Heléne Karlman Tiina Rintala

EfCCNa March 2011


Performance

‣ The study started in february 2008 and was

terminated one year later.

‣ 112 patients with neurosurgical or neurological

diagnosis were included.

‣ Randomly 41 patients got heated humidification

and 71 were treated with HME-filter, these 71

patients served as our controlgroup

‣ Aged varied between 15 – 85 years

Heléne Karlman Tiina Rintala

EfCCNa March 2011


Inclusion criteria

Exclusion criteria

‣ Patients with

neurosurgical or

neurological diagnosis

‣ Patients nursed > 48

hours and in need of

invasive mechanical

ventilation >12 hours

‣ Patients admitted with

other diagnosis

‣ Patients transfered to

another ICU due to lack

of NICU beds

‣ Patients who died at

NICU.

‣ Patients nursed < 48

hours

Heléne Karlman Tiina Rintala

EfCCNa March 2011


What data did we use

‣ Glasgow Coma Scale

at arrival to

emergency or NICU

‣ NICU length of stay

‣ Duration of invasive

mechanical ventilation

‣ Performed

bronchoscopies

‣ Bacteria growth

‣ Airway infection

Heléne Karlman Tiina Rintala

EfCCNa March 2011


GCS on admission

70%

60%

50%

n.s.

n.s.

Humidified

Control

40%

30%

20%

10%

0%

GCS 3-8 GCS 9-15

Heléne Karlman Tiina Rintala

EfCCNa March 2011


Time spent in NICU

and on ventilator (hours)

n.s.

300

250

200

150

SEM

30,3

SEM

19,8

SEM

23,5

n.s.

SEM

19,0

Humidified

Control

100

50

0

Time in NICU

Time on

ventilator

Heléne Karlman Tiina Rintala

EfCCNa March 2011


Diagnosed VAP

35%

30%

n.s.

25%

20%

15%

10%

5%

0%

Humidified

Control

Heléne Karlman Tiina Rintala

EfCCNa March 2011


Conclusion

‣ So the conclusion of our results is that since no

improvements were seen in this patientgroup

concerning NICU length of stay or duration of

invasive mechanical ventilation, the unit is not

going to use heated humidification as a standard

procedure.

‣ However benefits were noticed during suctions of

lower airways and broncoscopies due to more

loose secretion.

Heléne Karlman Tiina Rintala

EfCCNa March 2011


Thank you for your attention

Tiina Rintala

tiina.rintala@karolinska.se

Helene Karlman

helene.karlman@karolinska.se


Bacteria growth

‣ Controlgroup Humified

Gram-positive coccus: 38 24

‣ Staff aureus, Staff coryne,

‣ KNS.

‣ Streptokock grupp A,B och C

‣ Enterococcus faecalis

‣ Aerococcus urinaae

‣ Gram-negative rods: 53 29

‣ Acinetobacter, E-coli,

‣ Hemofilus influensa, Klebsiella, Pseudomonas, Bacteroides, Enterobacter aerogenes,

enterobacter cloace, Moraxella, Morganella morgani, Serratia marcescens, Prevotella Spices,

Stenotrophmonas,

‣ Candida: 15 8

‣ Candida - dubliniensis

‣ - tropicalis

‣ - albicans

‣ - jästsvamp

Heléne Karlman Tiina Rintala

EfCCNa March 2011

More magazines by this user
Similar magazines