The design and application of ventilator humidifier with infusing fluid automatically_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

YANG Lin ^1,2 , YAO Li ^1,2 ,  ZHANG Zhigang ^1,2 , ZHAGN Caiyun ¹ , JIANG Youfei ¹ , YUE Weigang ¹ , FENG Xin ¹ , GAO Huiya ^1,2 , LI Na ^1,2 , HAN Lulu ^1,2 , CHEN Ke ^1,2 , WANG Shengjun ^1,2 , SHEN Xiping ³

1. The First Hospital of Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
2. School of Nursing, Lanzhou University, Lanzhou, Gansu 730000, P. R. China;
3. School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, P. R. China;

Corresponding?author：

ZHANG Zhigang, Email: zzg3444@163.com

Keywords：

Ventilator humidifier; Humidification; Mechanical ventilation

DOI：

10.7507/1671-6205.201907005

Video：

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Objective To design a ventilator humidifier that can ensure water level and infuse fluid automatically, and evaluate its application effect in patients with mechanical ventilation.Methods Thirty-eight patients who received mechanical ventilation in ICU from March to June in 2019 were included. According to the order of admission, they were divided into a study group with 18 patients and a control group with 20 patients. Different ventilator humidifiers were used. The study group used self-designed ventilator humidifier, and the control group used the MR370 humidifier. The cases of sputum viscosity with Ⅲ degree after 48 hours’ mechanical ventilation, the times of fluid infusion and the total amount of fluid infusion were compared. The times of pouring out condensate water and the total amount of pouring out condensate water in 24 hours were also compared.Results The times of infusing liquid in the study group in 24 hours was less than that in the control group (3.3±0.5 vs. 11.2±1.7, P<0.01), but the other indicators were not statistically significant between the two groups (all P>0.05).Conclusions The self-designed ventilator humidifier can be used for patients with mechanical ventilation, which can keep the water level at the water line all the time and is beneficial to humidification treatment. It can reduce the times of fluid infusion and nurses' workload.

Citation： YANG Lin, YAO Li, ZHANG Zhigang, ZHAGN Caiyun, JIANG Youfei, YUE Weigang, FENG Xin, GAO Huiya, LI Na, HAN Lulu, CHEN Ke, WANG Shengjun, SHEN Xiping. The design and application of ventilator humidifier with infusing fluid automatically. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(6): 598-602. doi: 10.7507/1671-6205.201907005 Copy

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2.	Gillies D, Todd DA, Foster JP, et al. Heat and moisture exchangers versus heated humidifiers for mechanically ventilated adults and children. Cochrane Database Syst Rev, 2017, 9: CD004711.
3.	曾定芬, 向明芳, 許仕英, 等. 呼吸機加溫加濕器中蒸餾水注入方法的改進. 中華護理雜志, 2007, 42(5): 471.
4.	藍冰仁, 葉紅. 機械加溫加濕器與氧氣霧化吸入濕化氣道在人工氣道中效果比較. 中國臨床護理, 2019, 11(2): 127-129.
5.	Birk R, H?ndel A, Wenzel A, et al. Heated air humidification versus cold air nebulization in newly tracheostomized patients. Head Neck, 2017, 39(12): 2481-2487.
6.	王靜, 皮紅英. 兩種不同氣道濕化方法對氣管切開患者影響的Meta分析. 中華危重病急救醫學, 2016, 28(1): 63-69.
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10.	藍惠蘭, 李雪球, 覃鐵和, 等. 機械通氣患者吸痰前氣管內滴注生理鹽水濕化的比較研究. 中華護理雜志, 2005, 40(8): 567-569.
11.	程輝, 張宗穎. 呼吸機管路中冷凝水的管理體會. 吉林醫學, 2013, 34(13): 2577-2578.
12.	羅春霞, 劉妙秋, 曾麗云, 等. 集束化護理在老年危重患者人工氣道管理中的應用. 護理實踐與研究, 2017, 14(16): 128-129.
13.	曾碰華, 吳靜冰, 鄭若菲. 呼吸機濕化器不同加水方法的效果評價與分析. 中國現代藥物應用, 2010, 4(15): 239-240.
14.	李秀瓊. 呼吸機濕化液不同加入方法與院內感染發生率的相關性研究. 解放軍護理雜志, 2006, 23(5): 23-24.
15.	孫曉林, 羅明琴. PDCA 循環在降低 ICU 呼吸機冷凝水傾倒不及時率中的應用. 青海醫藥雜志, 2018, 48(2): 32-34.
16.	谷紅俊, 賈艷紅. 呼吸機持續加水與間斷加水方法的效果觀察. 護理研究, 2011, 25(5): 1165-1166.
17.	李莉, 顏萍, 楊益, 等. 護理人員情緒勞動現狀及其影響因素分析. 護理學雜志, 2016, 31(20): 60-62.
18.	陳競萌, 尤黎明, 鄭晶, 等. 醫院內科、外科和 ICU 病區護士特征分布以及護理工作環境分析. 中國護理管理, 2012, 12(7): 20-23.
19.	豆春霞, 劉可, 尤黎明, 等. 病房護士人力配置與工作超時相關性研究. 中國護理管理, 2012, 12(5): 23-25.
20.	劉芳, 龔立超, 阮征, 等. 重癥腦損傷機械通氣患者加溫加濕罐水位控制的臨床驗證效果. 解放軍護理雜志, 2017, 34(10): 33-35.
21.	文庭亮, 王璉, 胡波, 等. ICU 不同人工氣道濕化器的應用及濕化管理. 長江大學學報, 2013, 10(3): 49-51.
22.	Vargas M, Chiumello D, Sutherasan Y, et al. Heat and moisture exchangers (HMEs) and heated humidifiers (HHs) in adult critically ill patients: a systematic review, meta-analysis and meta-regression of randomized controlled trials. Crit Care, 2017, 21(1): 123.
23.	Haziot N, Ibrahim M, Zhu K, et al. Impact of leaks and ventilation parameters on the efficacy of humidifiers during home ventilation for tracheostomized patients: a bench study. BMC Pulm Med, 2019, 19(1): 43.

1. Esenda?l? D, Sar?n? Ula?l? S, Esquinas A. Humidification therapy: long-term effects in COPD and OSAS patients. Tuberk Toraks, 2018, 66(1): 57-63.
2. Gillies D, Todd DA, Foster JP, et al. Heat and moisture exchangers versus heated humidifiers for mechanically ventilated adults and children. Cochrane Database Syst Rev, 2017, 9: CD004711.
3. 曾定芬, 向明芳, 許仕英, 等. 呼吸機加溫加濕器中蒸餾水注入方法的改進. 中華護理雜志, 2007, 42(5): 471.
4. 藍冰仁, 葉紅. 機械加溫加濕器與氧氣霧化吸入濕化氣道在人工氣道中效果比較. 中國臨床護理, 2019, 11(2): 127-129.
5. Birk R, H?ndel A, Wenzel A, et al. Heated air humidification versus cold air nebulization in newly tracheostomized patients. Head Neck, 2017, 39(12): 2481-2487.
6. 王靜, 皮紅英. 兩種不同氣道濕化方法對氣管切開患者影響的Meta分析. 中華危重病急救醫學, 2016, 28(1): 63-69.
7. 中華醫學會重癥醫學分會. 機械通氣臨床應用指南(2006). 中國危重病急救醫學, 2007, 19(2): 65-72.
8. 藍惠蘭, 鄧旭萍, 陳瀚熙, 等. 機械通氣呼吸濕化器濕化研究進展. 護理學雜志, 2013, 28(13): 94-97.
9. Lellouche F, Taillé S, Maggiore SM, et al. Influence of ambient and ventilator output temperatures on performance of heated-wire humidifiers. Am J Respir Crit Care Med, 2004, 170(10): 1073-1079.
10. 藍惠蘭, 李雪球, 覃鐵和, 等. 機械通氣患者吸痰前氣管內滴注生理鹽水濕化的比較研究. 中華護理雜志, 2005, 40(8): 567-569.
11. 程輝, 張宗穎. 呼吸機管路中冷凝水的管理體會. 吉林醫學, 2013, 34(13): 2577-2578.
12. 羅春霞, 劉妙秋, 曾麗云, 等. 集束化護理在老年危重患者人工氣道管理中的應用. 護理實踐與研究, 2017, 14(16): 128-129.
13. 曾碰華, 吳靜冰, 鄭若菲. 呼吸機濕化器不同加水方法的效果評價與分析. 中國現代藥物應用, 2010, 4(15): 239-240.
14. 李秀瓊. 呼吸機濕化液不同加入方法與院內感染發生率的相關性研究. 解放軍護理雜志, 2006, 23(5): 23-24.
15. 孫曉林, 羅明琴. PDCA 循環在降低 ICU 呼吸機冷凝水傾倒不及時率中的應用. 青海醫藥雜志, 2018, 48(2): 32-34.
16. 谷紅俊, 賈艷紅. 呼吸機持續加水與間斷加水方法的效果觀察. 護理研究, 2011, 25(5): 1165-1166.
17. 李莉, 顏萍, 楊益, 等. 護理人員情緒勞動現狀及其影響因素分析. 護理學雜志, 2016, 31(20): 60-62.
18. 陳競萌, 尤黎明, 鄭晶, 等. 醫院內科、外科和 ICU 病區護士特征分布以及護理工作環境分析. 中國護理管理, 2012, 12(7): 20-23.
19. 豆春霞, 劉可, 尤黎明, 等. 病房護士人力配置與工作超時相關性研究. 中國護理管理, 2012, 12(5): 23-25.
20. 劉芳, 龔立超, 阮征, 等. 重癥腦損傷機械通氣患者加溫加濕罐水位控制的臨床驗證效果. 解放軍護理雜志, 2017, 34(10): 33-35.
21. 文庭亮, 王璉, 胡波, 等. ICU 不同人工氣道濕化器的應用及濕化管理. 長江大學學報, 2013, 10(3): 49-51.
22. Vargas M, Chiumello D, Sutherasan Y, et al. Heat and moisture exchangers (HMEs) and heated humidifiers (HHs) in adult critically ill patients: a systematic review, meta-analysis and meta-regression of randomized controlled trials. Crit Care, 2017, 21(1): 123.
23. Haziot N, Ibrahim M, Zhu K, et al. Impact of leaks and ventilation parameters on the efficacy of humidifiers during home ventilation for tracheostomized patients: a bench study. BMC Pulm Med, 2019, 19(1): 43.

Chinese Journal of Respiratory and Critical Care Medicine

The design and application of ventilator humidifier with infusing fluid automatically

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