Humidification and mucus transport in critical patients: Clinical and therapeutic implications

Nenhuma Miniatura disponível
Citações na Scopus
0
Tipo de produção
bookPart
Data de publicação
2012
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER BERLIN HEIDELBERG
Citação
Nakagawa, N. K.; Nascimento, J. A.; Nicola, M. L.; Saldiva, P. H. N.. Humidification and mucus transport in critical patients: Clinical and therapeutic implications. In: . HUMIDIFICATION IN THE INTENSIVE CARE UNIT: THE ESSENTIALS: SPRINGER BERLIN HEIDELBERG, 2012. p.215-225.
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
An adult man inhales more than 12,000 l of air per day, which may contain particles and microorganisms. The epithelium of the conducting airways, from the nose to the bronchioli, are anatomically and physiologically designed to protect the alveoli by providing clean, warmed and fully saturated air at this level, where an efficient gas exchange must occur, and by providing specific defense mechanisms, such as trapping particles and microorganisms in the mucus and mucociliary transport of these agents in the direction of the oropharynx, where they will be swallowed or expectorated. Mucociliary transport (MCT) is an important respiratory defense mechanism, which efficiency depends on the equilibrium among three major components: ciliary beating, airway surface liquid (the periciliary liquid and mucus), and the interaction between cilia and mucus. In the intensive care unit (ICU) and emergency department, many factors can increase the risks of mucus transport dysfunction. Among them, artificial inspired air conditioning is a basic factor with physiological and clinical impact in critically ill patients. © Springer-Verlag Berlin Heidelberg 2012.
Palavras-chave
Referências
  1. Branson, R.D., Gentile, M.A., Is humidification always necessary during noninvasive ventilation in the hospital? (2010) Respir Care, 55, pp. 209-216
  2. Nakagawa, N.K., Macchione, M., Petrolino, H.M., Effects of a heat and moisture exchanger and a heated humidifier on respiratory mucus in patients undergoing mechanical ventilation (2000) Crit Care Med, 28, pp. 312-317
  3. Martin, C., Perrin, G., Gevaudan, M.J., Heat and moisture exchangers and vaporizing humidifiers in the intensive care unit (1990) Chest, 97 (1), pp. 144-149
  4. Sottiaux, T., Mignolet, G., Damas, P., Comparative evaluation of three heat and moisture exchangers during short-term postoperative mechanical ventilation (1993) Chest, 104, pp. 220-224
  5. Ricard, J.D., Le Mière, E., Markowicz, P., Efficiency and safety of mechanical ventilation with a heat and moisture exchanger changed only once a week (2000) Am J Respir Crit Care Med, 161, pp. 104-109
  6. Girault, C., Breton, L., Richard, J.C., Mechanical effects of airway humidification devices in difficult to wean patients (2003) Crit Care Med, 31, pp. 1306-1311
  7. Jaber, S., Pigeot, J., Fodil, R., Long-term effects of different humidification systems on endotracheal tube patency evaluation by the acoustic reflection method (2004) Anesthesiology, 100, pp. 782-788
  8. Cinnella, G., Giardina, C., Fischetti, A., Airways humidification during mechanical ventilation. Effects on tracheobronchial ciliated cells morphology (2005) Minerva Anestesiol, 71, pp. 585-593
  9. Lacherade, J.C., Auburtin, M., Cerf, C., Impact of humidification systems on ventilatorassociated pneumonia: A randomized multicenter trial (2005) Am J Respir Crit Care Med, 172, pp. 1276-1282
  10. Lorente, L., Lecuona, M., Jiménez, A., Ventilator-associated pneumonia using a heated humidifier or a heat and moisture exchanger: A randomized controlled trial (2006) Crit Care, 10, pp. 1-7
  11. Siempos, I.I., Vardakas, K.Z., Kopterides, P., Impact of passive humidification on clinical outcomes of mechanically ventilated patients: A meta-analysis of randomized controlled trials (2007) Crit Care Med, 35, pp. 2843-2851
  12. Solomita, M., Palmer, L.B., Daroowalla, F., Humidification and secretion volume in mechanically ventilated patients (2009) Respir Care, 54, pp. 1329-1335
  13. Lellouche, F., Maggiore, S.M., Deye, N., Effect of the humidification device on the work of breathing during noninvasive ventilation (2002) Intensive Care Med, 28, pp. 1582-1589
  14. Nava, S., Cirio, S., Fanfulla, F., Comparison of two humidification systems for longterm noninvasive mechanical ventilation (2008) Eur Respir J, 32, pp. 460-464
  15. Boyer, A., Vargas, F., Hilbert, G., Small dead space heat and moisture exchangers do not impede gas exchange during noninvasive ventilation: A comparison with a heated humidifier (2010) Intensive Care Med, 36, pp. 1348-1354
  16. Humidifiers for medical use (1988) ISO, 60, p. 14. , 8185:1988(E)
  17. Nakagawa, N.K., Franchini, M.L., Driusso, P., Mucociliary clearance is impaired in acutely ill patients (2005) Chest, 128, pp. 2772-2777