Inadequate humidification of inspired gases can cause a variety of serious problems, and humidification has accordingly become an important aspect of modern intensive care medicine. This book is designed to serve as a practical guide for clinicians, providing information on the theoretical background of humidification, the equipment, and its optimal use. The book starts by examining the physiological basis of humidification. Current devices are then discussed, with careful attention to factors influencing their performance and methods to evaluate their effectiveness. The two scenarios of mechanical and non-mechanical ventilation are considered, and the issue of ventilator-associated pneumonia is addressed in detail. Further chapters focus on such topics as humidification following tracheostomy, humidification of the artificial airway during secretion management, measurement of inspired gas temperature in the ventilated neonate, and humidification in the home care setting.

This dissertation, "The Use of Humidification System to Reduce the Work of Breathing in Mechanical Ventilated Patients" by Wai-ki, Cheung, 張慧琪, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Critically ill patients in an intensive care unit (ICU) often require mechanical ventilation (MV). Humidification systems are essential devices for MV which replace the natural heat and moisture exchange process of inspired gases. A heat and moisture exchanger (HME) is commonly used for the humidification of MV patients in ICU. In contrast, a heated humidifier (HH) that is a more complicated device is used only for prolonged MV patients because of its higher cost and nurse workload. However, HME may increase the breathing workload of patients, thereby inflicting damage to their respiratory function, especially among respiratory failure patients. However, there was no evidence-based guideline that instructs nurses on choosing humidification devices in ICU. This dissertation aimed to 1) evaluate the current evidence and formulate evidence-based guideline in selecting a humidification device for mechanically ventilated acute respiratory distress syndrome (ARDS) patients in reducing the risks of breathing workload; 2) assess its implementation potential, as well as its feasibility and transferability; and 3) develop implementation strategies and evaluation plans for the use of this device in an adult ICU. Three electronic databases, namely, Proquest, Ovid, and Google Scholar, were searched for randomized controlled trials (RCTs) of humidification systems for MV. Eight articles were retrieved. Their reference lists were read and found two additional RCT. Four high-quality RCT showed that HH increased the breathing workload more than HME. Several studies showed that HME has potential drawbacks of significantly increase airway resistance, minute ventilation, CO2 retention, and respiratory discomfort. However, studies showed that no significant difference of ventilator-associated pneumonia (VAP) rate between HME and HH. The initial application of HME is safer and less costlyl. However, prolonged use of HME in ARDS patients may induce further workload on the respiratory system and worsen treatment progress. An evidence-based clinical guideline in choosing the humidification system was formulated and assessed using the appraisal instruments of Scottish Intercollegiate Guideline Network. It is deemed to be transferable with patient characteristics, clinical situation, and organizational infrastructure similar to studies evaluated the suggested innovation. Feasibility was also assessed and is considered to be high. The setup and running cost per year were HKD17450 and HKD6600. Although the humidification system had no actual cost reduction, non-material benefits such as prevention of tube blockage, reduction in breathing workload, and respiratory discomfort were more important than the cost. An implementation plan including a one-month communication plan with stakeholders and one-month pilot testing were developed. The evaluation of the guideline will last for 10 months. The effectiveness of the innovation will be determined by the reduction in breathing workload, cost and benefit ratio, and staff satisfaction level. DOI: 10.5353/th_b5088284 Subjects: Respiratory intensive care Artificial respiration

Medical Ventilator System Basics: A clinical guide is a user-friendly guide to the basic principles and the technical aspects of mechanical ventilation and modern complex ventilator systems. Designed to be used at the bed side by busy clinicians, this book demystifies the internal workings of ventilators so they can be used with confidence for day-to-day needs, for advanced ventilation, as well as for patients who are difficult to wean off the ventilator. Using clear language, the author guides the reader from pneumatic principles to the anatomy and physiology of respiration. Split into 16 easy to read chapters, this guide discusses the system components such as the ventilator, breathing circuit, and humidifier, and considers the major ventilator functions, including the control parameters and alarms. Including over 200 full-colour illustrations and practical troubleshooting information you can rely on, regardless of ventilator models or brands, this guide is an invaluable quick-reference resource for both experienced and inexperienced users.

An international panel of experts has assembled one of the finest reviews on humidification and filtration! Both concepts are thoroughly examined, as are devices and filters. ARDS, SARDS, hepatitis C, pneumonia and other respiratory diseases are addressed, as is the pediatric population. Don't miss this one!

The sixth edition provides practical, concise information on all aspects of intensive care. Written in a clear and accessible style and now for the first time presented in colour throughout, this book enables the user to manage a patient in an ICU setting effectively without recourse to large text/reference works or specialized monographs. This thoroughly revised and updated edition reflects the best and most current practice from leading centres in Australia, the UK and Western Europe. Information on management and treatment of conditions is balanced by pathophysiological and pharmacological background. This is not just a "cook book" of procedures. It provides all of the essential information for candidates wishing to pass professional examinations. Addition of colour throughout to highlight summary boxes, tables, charts and flow diagrams.Will make key information more accessible, easier and faster to retrieve. Pitfalls in treatment and management emphasized in each chapter.Providers the user with expert advice on practical issues that will be encountered on a day-to-day basis in the ICU. Keeps the user abreast of the latest developments in diagnosis and management.

Audience: Critical Care Physicians, Pulmonary Medicine Physicians; Respiratory Care Practitioners; Intensive Care Nurses Author is the most recognized name in Critical Care Medicine Technical and clinical developments in mechanical ventilation have soared, and this new edition reflects these advances Written for clinicians, unlike other books on the subject which have primarily an educational focus

Covers essential information on maths, physics and clinical measurement for anaesthesia and critical care.

For nearly 40 years, Oh's Intensive Care Manual has been the quick reference of choice for ICU physicians at all levels of experience. The revised 8th edition maintains this tradition of excellence, providing fast access to practical information needed every day in today's intensive care unit. This bestselling manual covers all aspects of intensive care in sufficient detail for daily practice while keeping you up to date with the latest innovations in the field. - New coverage of the latest developments in ICU imaging techniques, including ultrasound. - New information on the latest advances in ECMO (Extracorporeal Membrane Oxygenation) for cardiac and respiratory failure, ARDS, septic shock, neurologic disorders, muscle function, and hemodynamic therapy. - New co-editor Dr. Jonathan Handy shares his knowledge and expertise on acid-base disturbances during critical illness, critical care transfers, intravenous fluid therapy, cardiovascular physiology, burn management, sepsis, and the immunological impact of surgery and burn injury. - Expert ConsultTM eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.