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Humidity during high-frequency oscillatory ventilation compared to intermittent positive pressure ventilation in extremely preterm neonates: an in-vitro and in-vivo observational study.
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  • Claude Danan,
  • Manon Tauzin,
  • Camille Jung,
  • Xavier Durrmeyer,
  • Laurence Caeymaex,
  • Charles Treussart,
  • Fabrice Decobert,
  • Bruno Louis
Claude Danan
Centre Hospitalier Intercommunal de Creteil

Corresponding Author:[email protected]

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Manon Tauzin
Centre Hospitalier Intercommunal de Creteil
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Camille Jung
Centre Hospitalier Intercommunal de Creteil
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Xavier Durrmeyer
Centre Hospitalier Intercommunal de Creteil
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Laurence Caeymaex
Centre Hospitalier Intercommunal de Creteil
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Charles Treussart
Centre Hospitalier Intercommunal de Creteil
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Fabrice Decobert
Centre Hospitalier Intercommunal de Creteil
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Bruno Louis
Universite Paris-Est Creteil Val de Marne
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Abstract

Background: Inappropriate humidification of inspired gas during mechanical ventilation can impair lung development in extremely low birthweight (ELBW) infants. Humidification depends on multiple factors, such as the heater-humidifier device used, type of ventilation, and environmental factors. Few studies have examined inspired gas humidification in these infants, especially during high-frequency oscillatory ventilation (HFOV). Our objective was to compare humidity during HFOV and intermittent positive pressure ventilation (IPPV), in vitro and in vivo. Methods: In-vitro and in-vivo studies used the same ventilator during both HFOV and IPPV. The bench study used a neonatal test lung and 2 heater-humidifiers with their specific circuits; the in-vivo study prospectively included preterm infants born before 28 weeks of gestation.  Results: On bench testing, mean absolute (AH) and relative (RH) humidity values were significantly lower during HFOV than IPPV (RH = 79.4% ± 8.1% vs 89.0% ± 6.2%, P<0.001). Regardless of the ventilatory mode, mean relative humidity significantly differed between the 2 heater-humidifiers (89.6% ± 6.7% vs 78.7% ± 6.8%, P=0.003). The in-vivo study included 10 neonates (mean ± SD gestational age: 25.7 ± 0.9 weeks and birth weight: 624.4 ± 96.1 g). Mean relative humidity during HFOV was significantly lower than during IPPV (74.6% ± 5.7% vs 83.0 ± 6.7%, P=0.004).  Conclusion: Relative humidity was significantly lower during HFOV than IPPV, both in vitro and in vivo. The type of heater-humidifier also influenced humidification. More systematic measurements of humidity of inspired gas, especially during HFOV, should be considered to optimize humidification and consequently lung protection in ELBW infants.
23 May 2022Submitted to Pediatric Pulmonology
23 May 2022Submission Checks Completed
23 May 2022Assigned to Editor
25 May 2022Reviewer(s) Assigned
15 Jun 2022Review(s) Completed, Editorial Evaluation Pending
15 Jun 2022Editorial Decision: Revise Minor
17 Aug 20221st Revision Received
17 Aug 2022Submission Checks Completed
17 Aug 2022Assigned to Editor
17 Aug 2022Reviewer(s) Assigned
29 Aug 2022Review(s) Completed, Editorial Evaluation Pending
03 Sep 2022Editorial Decision: Accept
Jan 2023Published in Pediatric Pulmonology volume 58 issue 1 on pages 66-72. 10.1002/ppul.26157