Heat-and-Moisture Exchangers Used With Biweekly Circuit Tubing Changes: Effect on Costs and Pneumonia Rates

AbstractIn 1991, heat-and-moisture exchangers were introduced with biweekly ventilator circuit tubing changes, resulting in elimination of multiple pieces of respiratory equipment and reduced labor costs. The annual savings were $157,000, totalling $1.5 million since the onset of the program. There have been no increases in rates of ventilator-associated pneumonia.

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HEAT AND MOISTURE EXCHANGERS-RELATED ERRORS AND ITS RELATION TO VENTILATOR-ASSOCIATED PNEUMONIA IN THE ICU

CHEST Journal ◽

10.1016/j.chest.2020.05.458 ◽

2020 ◽

Vol 157 (6) ◽

pp. A408

Author(s):

A. Alqahtani ◽

R. Evley

Keyword(s):

Ventilator Associated Pneumonia ◽

Heat And Moisture Exchangers ◽

Heat And Moisture

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Double-heater-wire circuits and heat-and-moisture exchangers and the risk of ventilator-associated pneumonia

Critical Care Medicine ◽

10.1097/01.ccm.0000201887.51076.31 ◽

2006 ◽

Vol 34 (3) ◽

pp. 687-693 ◽

Cited By ~ 46

Author(s):

Robert J. Boots ◽

Narelle George ◽

Joan L. Faoagali ◽

John Druery ◽

Kevin Dean ◽

...

Keyword(s):

Ventilator Associated Pneumonia ◽

Heat And Moisture Exchangers ◽

Heater Wire ◽

Heat And Moisture

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Ventilator Circuits, Humidification and Ventilator-Associated Pneumonia

Canadian Respiratory Journal ◽

10.1155/1996/972402 ◽

1996 ◽

Vol 3 (6) ◽

pp. 397-402

Author(s):

Dean Hess

Keyword(s):

Mechanical Ventilation ◽

Moisture Loss ◽

Ventilator Associated Pneumonia ◽

Ventilator Circuit ◽

Mechanically Ventilated ◽

Artificial Airway ◽

Condensate Formation ◽

Heated Humidifiers ◽

Technical Issues ◽

Heat And Moisture

Technical issues in the care of mechanically ventilated patients include those related to the ventilator circuit, humidification and ventilator-associated pneumonia. Principal issues related to ventilator circuits include leaks and compression volume. Circuit compression volume affects delivered tidal volume as well as measurements of auto-positive end-expiratory pressure and mixed expiredPCO2. Resistance through the ventilator circuit contributes to patient-ventilator dyssynchrony during assisted modes of mechanical ventilation. Adequate humidification of inspired gas is necessary to prevent heat and moisture loss. Common methods of humidification of inspired gas during mechanical ventilation include use of active heated humidifiers and passive artificial noses. Artificial noses are less effective than active humidifiers and are best suited to short term use. With active humidifiers, the circuit can be heated to avoid condensate formation. However, care must be exercised when heated circuits are used to avoid delivery of a low relative humidity and subsequent drying of secretions in the artificial airway. Although pneumonia is a complication of mechanical ventilation, these pneumonias are usually the result of aspiration of pharyngeal secretions and are seldom related to the ventilator circuit. Ventilator circuits do not need to be changed more frequently than weekly for infection control purposes, and the incidence of ventilator-associated pneumonia may be greater with more frequent circuit changes.

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