Double-heater-wire circuits and heat-and-moisture exchangers and the risk of XXXX .

@entity1 @entity55 @entity2489 @entity358 @entity2507
OBJECTIVE: To compare the incidence of @entity2489 ( @entity2489 ) in @entity1 ventilated in intensive care by means of circuits humidified with a hygroscopic heat-and-moisture exchanger with a bacterial viral filter (HME) or hot-water humidification with a heater wire in both inspiratory and expiratory circuit limbs (DHW) or the inspiratory limb only (SHW). DESIGN: A prospective, randomized trial. SETTING: A metropolitan teaching hospital's general intensive care unit. @entity1 : Three hundred eighty-one @entity1 requiring a minimum period of mechanical ventilation of 48 hrs. INTERVENTIONS: @entity1 were randomized to humidification with use of an HME (n=190), SHW (n=94), or DHW (n=97). MEASUREMENTS AND MAIN RESULTS: Study end points were @entity2489 diagnosed on the basis of @entity358 Score (CPIS) (), HME resistance after 24 hrs of use, endotracheal tube resistance, and HME use per @entity1 . @entity2489 occurred with similar frequency in all groups (13%, HME; 14%, DHW; 10%, SHW; p=0.61) and was predicted only by current smoking (adjusted odds ratio [AOR], 2.1; 95% confidence interval [CI], 1.1-3.9; p=.03) and ventilation days (AOR, 1.05; 95% CI, 1.0-1.2; p=.001); @entity2489 was less likely for @entity1 with an admission diagnosis of @entity55 (AOR, 0.40; 95% CI, 0.4-0.2; p=.04). HME resistance after 24 hrs of use measured at a gas flow of 50 L/min was 0.9 cm @entity2507 (0.4-2.9). Endotracheal tube resistance was similar for all three groups (16-19 cm @entity2507 min/L; p=.2), as were suction frequency, secretion thickness, and blood on suctioning (p=.32, p=.06, and p=.34, respectively). The HME use per @entity1 per day was 1.13. CONCLUSIONS: Humidification technique does not influence either @entity2489 incidence or secretion characteristics, but HMEs may have air-flow resistance higher than manufacturer specifications after 24 hrs of use.
