title: A change in humidification system can eliminate endotracheal tube occlusion.
abstract: OBJECTIVE
  Inadequate airway humidification can result in endotracheal tube occlusion. There is evidence that heat and moisture exchangers (HMEs) are more prone to endotracheal tube occlusion than heated humidifiers (HHs) that contain a heated wire circuit. We aimed to compare the incidence of endotracheal tube occlusion while introducing a new dual-heated wire circuit HH in place of an established hydrophobic HME.
  
  
  METHODS
  This was a prospective observational study. All patients who required intubation were included in our analysis. Univariate statistical analysis was performed using a Fisher exact test. P < .05 was considered statistically significant.
  
  
  RESULTS
  There were 158 patients in the HME group and 88 patients in the HH group. The incidence of endotracheal tube occlusion was 5.7% in the HME group and 0% in the HH group. Statistical analysis revealed a significant difference between the 2 groups (P = .02). In light of this finding, we changed our practice to provide humidification exclusively by HH. In the subsequent 18-month period, there were no further episodes of endotracheal tube occlusion.
  
  
  CONCLUSIONS
  Our study demonstrates that there is a significant increase in the incidence of endotracheal tube occlusion when using a hydrophobic HME compared with an HH and that using a dual-heated wire circuit HH can eliminate endotracheal tube occlusion.
authors: Department of Anaesthesia and Critical Care, Queen Elizabeth Hospital, Gayton Road, Kings Lynn, Norfolk, UK, PE30 4ET. ajdoyle@gmail.com
authors: Alex
authors: A
authors: Doyle
authors: Manasi
authors: M
authors: Joshi
authors: Peter
authors: P
authors: Frank
authors: Thomas
authors: T
authors: Craven
authors: Parvez
authors: P
authors: Moondi
authors: Peter
authors: P
authors: Young
mesh_terms: D000368:Aged; D003422:Critical Care; D004739:England; D005260:Female; D006801:Humans; D006813:Humidity; D015994:Incidence; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome