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Effect of Inspiratory Absolute Humidity on Leak During NPPV

Received: 12 September 2018     Accepted: 27 May 2019     Published: 18 June 2019
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Abstract

Noninvasive ventilator connects a one-way circuit with leak and delivers inspired gas via the upper airway tract. A heated humidifier don’t have to connect to contain heat and moisture exchange humidity in the upper airway functions. However, there are many case connecting a heated humidifier to be inadequate humidity in the upper airway. The purpose of this study was to clarify the influence of absolute humidity on leak and inspiratory positive airway pressure during noninvasive positive pressure ventilation. We connected respiratory machine, a heated humidifier and a model lung via two type circuits. One circuit was a single-limb breathing with an exhalation port and another was two- way circuits to distinguish the inspiratory from the expiratory via Y-piece. Two heated humidifiers were included in both inspiratory and expiratory circuits to simulate the physical lung. Relative humidity, temperature and flow rate were measured for 30 minutes. Absolute humidity was calculated using the Teten’s equation and a gas state equation with relative humidity and temperature. In results, flow rate increased and absolute humidity decreased, when leak volume increased. We presumed that warmer humidified gas was discharged through the leak port with increasing flow rate to compensate leak. However, absolute humidity slightly was not associated with higher inspiratory positive airway pressure at the steady leak. We supposed that expiratory gas was not capable to discharge due to increasing flow rate and might be accumulated into the mask. The expired gas temperature accumulated in the mask might affect the inspired absolute humidity. Consequently, we are desirable to measure the inspired gas temperature and absolute humidity. In conclusion, absolute humidity would depend on leak during noninvasive positive pressure ventilation.

Published in International Journal of Biomedical Science and Engineering (Volume 7, Issue 1)
DOI 10.11648/j.ijbse.20190701.13
Page(s) 16-19
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

NPPV, Leak, Absolute Humidity

References
[1] N. S. Hill. “The Worldwide Spread of Noninvasive Ventilation; Too Much, Too Little or Just Right?,” Tanaffos, vol. 12, pp. 6–8, 2013.
[2] T. Kato, S. Suda, and T. Kasai. “Positive airway pressure therapy for heart failure,” World J Cardiol 2014, vol. 26, pp. 1175-91.
[3] R. Scala and L. Pisani, “Noninvasive ventilation in acute respiratory failure: which recipe for success?,” Eur Respir Rev 2018, vol. 27: 180029 doi: 10.1183/16000617.0029-2018.
[4] S. Yamashita, T. Dohi, K. Narui, and S. Momomura. “Therapeutic efficacy of continuous positive airway pressure in obstructive sleep apnea patients with acute aortic dissection: a case report,” J Atheroscler Thromb, vol. 17, pp. 999-1002, 2010.
[5] D. R. Hess. “Patient-ventilator interaction during noninvasive ventilation,” Respir Care, vol. 56, pp. 153-65, 2011.
[6] S. Mehta, F. D. McCool, and N. S. Hill. “Leak compensation in positive pressure ventilators: a lung model study,” Eur Respir J, vol. 17, pp. 259-67, 2001.
[7] J. H. Storre, P. Bohm, M. Dreher, and W. Windisch. “Clinical impact of leak compensation during non-invasive ventilation,” Respir Med, vol. 103, pp. 1477-83, 2009.
[8] American Association for Respiratory Care, R. D. Restrepo, and B. K. Walsh. “Humidification during invasive and noninvasive mechanical ventilation: 2012,” Respir Care, vol. 57, pp. 782-788, 2012.
[9] G. H. Wiest, F. S. Fuchs, W. M. Brueckl, G. Nusko,I. A. Harsch, E. G. Hahn, and J. H. Ficker. “In vivo efficacy of heated and non-heated humidifiers during nasal continuous positive airway pressure (nCPAP)-therapy for obstructive sleep apnea,” Respir Med, vol. 94, pp. 364-8, 2000.
[10] Y. Fischer, T. Keck T, R. Leiacker, A. Rozsasi, G. Rettinger, and P. M. Gruen. “Effects of nasal mask leak and heated humidification on nasal mucosa in the therapy with nasal continuous positive airway pressure (nCPAP),” Sleep Breath, vol. 12, pp. 353-7, 2008.
[11] A. E. Holland, L. Denehy, C. A. Buchan, and J. W. Wilson, “Efficacy of a heated passover humidifier during noninvasive ventilation: a bench study,” Respir Care, vol. 52, pp. 38-44, 2007.
[12] O. Tetens, “Uber einige meteorologische Begriffe,” Zeitschrift Geophysic, vol. 6, pp. 297–309, 1930.
[13] J. Oto, E. Nakataki, N. Okuda, M. Onodera, H. Imanaka, and M. Nishimura. “Hygrometric properties of inspired gas and oral dryness in patients with acute respiratory failure during noninvasive ventilation,” Respir Care, vol. 59, pp. 39-45, 2014.
[14] M. Antonelli, M. A. Pennisi, P. Pelosi, C. Gregoretti, V. Squadrone, M. Rocco, L. Cecchini, D. Chiumello, P. Severgnini, R. Proietti, P. Navalesi, and G. Conti. “Noninvasive Positive Pressure Ventilation Using a Helmet in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Feasibility Study,” Anesthesiology, vol.100, pp. 16-24, 2004.
[15] J. Lukácsovits, A. Carlucci, N. Hill, P. Ceriana, L. Pisani, A. Schreiber, P. Pierucci, G. Losonczy, and S. Nava. “Physiological changes during low- and high-intensity noninvasive ventilation,” Eur. Respir. J, vol. 39, pp. 869-875, 2012.
Cite This Article
  • APA Style

    Yuri Fueda, Takuya Kataoka, Fuka Matsuda. (2019). Effect of Inspiratory Absolute Humidity on Leak During NPPV. International Journal of Biomedical Science and Engineering, 7(1), 16-19. https://doi.org/10.11648/j.ijbse.20190701.13

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    ACS Style

    Yuri Fueda; Takuya Kataoka; Fuka Matsuda. Effect of Inspiratory Absolute Humidity on Leak During NPPV. Int. J. Biomed. Sci. Eng. 2019, 7(1), 16-19. doi: 10.11648/j.ijbse.20190701.13

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    AMA Style

    Yuri Fueda, Takuya Kataoka, Fuka Matsuda. Effect of Inspiratory Absolute Humidity on Leak During NPPV. Int J Biomed Sci Eng. 2019;7(1):16-19. doi: 10.11648/j.ijbse.20190701.13

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  • @article{10.11648/j.ijbse.20190701.13,
      author = {Yuri Fueda and Takuya Kataoka and Fuka Matsuda},
      title = {Effect of Inspiratory Absolute Humidity on Leak During NPPV},
      journal = {International Journal of Biomedical Science and Engineering},
      volume = {7},
      number = {1},
      pages = {16-19},
      doi = {10.11648/j.ijbse.20190701.13},
      url = {https://doi.org/10.11648/j.ijbse.20190701.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbse.20190701.13},
      abstract = {Noninvasive ventilator connects a one-way circuit with leak and delivers inspired gas via the upper airway tract. A heated humidifier don’t have to connect to contain heat and moisture exchange humidity in the upper airway functions. However, there are many case connecting a heated humidifier to be inadequate humidity in the upper airway. The purpose of this study was to clarify the influence of absolute humidity on leak and inspiratory positive airway pressure during noninvasive positive pressure ventilation. We connected respiratory machine, a heated humidifier and a model lung via two type circuits. One circuit was a single-limb breathing with an exhalation port and another was two- way circuits to distinguish the inspiratory from the expiratory via Y-piece. Two heated humidifiers were included in both inspiratory and expiratory circuits to simulate the physical lung. Relative humidity, temperature and flow rate were measured for 30 minutes. Absolute humidity was calculated using the Teten’s equation and a gas state equation with relative humidity and temperature. In results, flow rate increased and absolute humidity decreased, when leak volume increased. We presumed that warmer humidified gas was discharged through the leak port with increasing flow rate to compensate leak. However, absolute humidity slightly was not associated with higher inspiratory positive airway pressure at the steady leak. We supposed that expiratory gas was not capable to discharge due to increasing flow rate and might be accumulated into the mask. The expired gas temperature accumulated in the mask might affect the inspired absolute humidity. Consequently, we are desirable to measure the inspired gas temperature and absolute humidity. In conclusion, absolute humidity would depend on leak during noninvasive positive pressure ventilation.},
     year = {2019}
    }
    

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  • TY  - JOUR
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    AU  - Yuri Fueda
    AU  - Takuya Kataoka
    AU  - Fuka Matsuda
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    N1  - https://doi.org/10.11648/j.ijbse.20190701.13
    DO  - 10.11648/j.ijbse.20190701.13
    T2  - International Journal of Biomedical Science and Engineering
    JF  - International Journal of Biomedical Science and Engineering
    JO  - International Journal of Biomedical Science and Engineering
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    PB  - Science Publishing Group
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    UR  - https://doi.org/10.11648/j.ijbse.20190701.13
    AB  - Noninvasive ventilator connects a one-way circuit with leak and delivers inspired gas via the upper airway tract. A heated humidifier don’t have to connect to contain heat and moisture exchange humidity in the upper airway functions. However, there are many case connecting a heated humidifier to be inadequate humidity in the upper airway. The purpose of this study was to clarify the influence of absolute humidity on leak and inspiratory positive airway pressure during noninvasive positive pressure ventilation. We connected respiratory machine, a heated humidifier and a model lung via two type circuits. One circuit was a single-limb breathing with an exhalation port and another was two- way circuits to distinguish the inspiratory from the expiratory via Y-piece. Two heated humidifiers were included in both inspiratory and expiratory circuits to simulate the physical lung. Relative humidity, temperature and flow rate were measured for 30 minutes. Absolute humidity was calculated using the Teten’s equation and a gas state equation with relative humidity and temperature. In results, flow rate increased and absolute humidity decreased, when leak volume increased. We presumed that warmer humidified gas was discharged through the leak port with increasing flow rate to compensate leak. However, absolute humidity slightly was not associated with higher inspiratory positive airway pressure at the steady leak. We supposed that expiratory gas was not capable to discharge due to increasing flow rate and might be accumulated into the mask. The expired gas temperature accumulated in the mask might affect the inspired absolute humidity. Consequently, we are desirable to measure the inspired gas temperature and absolute humidity. In conclusion, absolute humidity would depend on leak during noninvasive positive pressure ventilation.
    VL  - 7
    IS  - 1
    ER  - 

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Author Information
  • Department of Medical Engineering, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan

  • Department of Medical Engineering, Faculty of Health Sciences, Himeji Dokkyo University, Himeji, Japan

  • Department of Medical Engineering, Faculty of Health Sciences, Himeji Dokkyo University, Himeji, Japan

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