Managing humidity support in intubated ventilated patients with coronavirus disease 2019 (COVID-19)

Clinical reviews have recommended the use of a heat and moisture exchanger (HME) for humidification during mechanical ventilation for intubated patients with infectious disease to minimize the risk of exposure the pathogens to healthcare workers (HCWs).2,3 HMEs are designed to capture heat and humid...

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Bibliographic Details
Published in:Infection Control & Hospital Epidemiology 2021-09, Vol.42 (9), p.1145-1146
Main Authors: Hui-Ling, Lin, Fink, James B, Ying-Huang, Tsai, Gwo-Hwa Wan
Format: Article
Language:English
Subjects:
Aerosols
Bacteria
Circuits
Coronaviruses
COVID-19
Disease transmission
Efficiency
Gas flow
Heat
Humidity
Intensive care
Letter to the Editor
Pathogens
Patients
Pneumonia
Ventilators
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Summary:Clinical reviews have recommended the use of a heat and moisture exchanger (HME) for humidification during mechanical ventilation for intubated patients with infectious disease to minimize the risk of exposure the pathogens to healthcare workers (HCWs).2,3 HMEs are designed to capture heat and humidity from exhaled gas and to condition inhaled gas to a temperature of 29–32°C with 29–32 mg/L absolute humidity. Patients managed under lung-protective strategies likely have low tidal volume, and the additional dead space of an HME may further increase the ventilation requirement as well as increase the partial pressure of carbon dioxide.1,2 Humans produce exhaled breath particles (EBP) ranging from 0.3 to 2.0 μm.4 EBP concentrations are positively associated with tidal volume, ventilation ratio (tidal volume to vital capacity), deep exhalation, and breath volume.4-6 A Taiwanese study found that the EBP concentration from mechanically ventilated patients were in the range of 0.47–2,554 particles per breath. [...]to protect HCWs caring for COVID-19 patients during mechanical ventilation, the of using an HME or a dual-limb heated ventilator circuit with minimal condensate production should be considered.
ISSN:0899-823X
1559-6834
DOI:10.1017/ice.2020.418