Humidification in the Intensive Care Unit The Essentials
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. The array of available devices is now formidable, and appropriate advice
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Antonio Matías Esquinas Editor
Humidification in the Intensive Care Unit The Essentials
Editor Antonio Matías Esquinas, M.D., Ph.D., FCCP International Fellow AARC Intensive Care Unit Hospital Morales Meseguer Avd Marques Velez s/n Murcia, Spain [email protected]
ISBN 978-3-642-02973-8 e-ISBN 978-3-642-02974-5 DOI 10.1007/978-3-642-02974-5 Springer Heidelberg Dordrecht London New York Library of Congress Control Number: 2011939481 © Springer-Verlag Berlin Heidelberg 2012 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the German Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Preface
Humidification in Intensive Care Medicine: A New and Ancient Science Evolving For several decades, we have realized the complexity of maintaining adequate respiratory function in critically ill patients, particularly during mechanical ventilation (MV), both invasive (IMV) and noninvasive (NIV), and have managed to maintain a reasonable balance between the patient and the ventilator in different scenarios [1–5]. Humidification is an essential part of any successful ventilatory strategy in critically ill patients. Nevertheless, the importance of this strategy and its probable impact on prognosis, weaning, control of bronchial secretions, gas exchange and complications, such as ventilator-associated pneumonia (VAP), are still underrecognized by many practitioners [6, 7]. We have not yet identified the ideal level of humidification needed for different clinical scenarios in critically ill patients, or the impact of external factors that may influence the level of absolute and relative humidity. Despite the fact that we have made significant developments in the technology of heated humidifiers or heated moisture exchangers, a great need for large clinical trials in patients with different types of respiratory diseases still exists. The new advances in the technology of IMV and NIV have increased the need for proper assessment of the requirements of ventilated patients
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