Gas pre-warming for improving performances of heated humidifiers in neonatal ventilation

Adequate temperature and humidification of gas delivered must be performed during long term neonatal ventilation to avoid potential adverse health effects. Literature shows that performances of heated humidifiers are, at least in some cases, quite poor. In this study, a novel approach to gas conditioning, consisting of gas warming upstream the humidification chamber, is presented. Gas pre-warming, in combination with a control strategy based on a mathematical model taking into account a number of parameters, allows to significantly improve the heated humidifier performances. The theoretical model has been validated and experimental trials have been carried out in the whole volumetric flow-rate (Q) range of neonatal ventilation (lower than 10 L·min−1). Experimental results (temperature values ranging from 36 °C to 38 °C and relative humidity values from 90 % to 98 % in the whole range of Q) show values very close to the ideal thermo-hygrometric conditions. The proposed solution allows to avoid vapor condensation at low flow rates and decrease of relative humidity at high flow rates.

[1]  X Viviand,et al.  Comparing two heat and moisture exchangers with one vaporizing humidifier in patients with minute ventilation greater than 10 L/min. , 1995, Chest.

[2]  François Lellouche,et al.  Influence of ambient and ventilator output temperatures on performance of heated-wire humidifiers. , 2004, American journal of respiratory and critical care medicine.

[3]  A. Schulze Respiratory gas conditioning and humidification. , 2007, Clinics in perinatology.

[4]  Arden L. Buck,et al.  New Equations for Computing Vapor Pressure and Enhancement Factor , 1981 .

[5]  G. Smaldone,et al.  Y-piece temperature and humidification during mechanical ventilation. , 2009, Respiratory care.

[6]  T Mashimo,et al.  Performance of heated humidifiers with a heated wire according to ventilatory settings. , 2001, Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine.

[7]  Sergio Silvestri,et al.  Mathematical model and minimal measurement system for optimal control of heated humidifiers in neonatal ventilation. , 2010, Medical engineering & physics.

[8]  Sergio Silvestri,et al.  A transistor based air flow transducer for thermohygrometric control of neonatal ventilatory applications. , 2008, The Review of scientific instruments.

[9]  Y. Jammes,et al.  Airway humidification with a heat and moisture exchanger in mechanically ventilated neonates , 2007, Intensive Care Medicine.

[10]  D. Dreyfuss,et al.  Bedside evaluation of efficient airway humidification during mechanical ventilation of the critically ill. , 1999, Chest.

[11]  Jan F. Kreider,et al.  Handbook of Heating, Ventilation, and Air Conditioning , 2000 .