title: Humidification during invasive and noninvasive mechanical ventilation: 2012.
abstract: We searched the MEDLINE, CINAHL, and Cochrane Library databases for articles published between January 1990 and December 2011. The update of this clinical practice guideline is based on 184 clinical trials and systematic reviews, and 10 articles investigating humidification during invasive  and noninvasive mechanical ventilation. The following recommendations are made following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scoring system: 1. Humidification is recommended on every patient receiving invasive mechanical ventilation. 2. Active humidification  is suggested for noninvasive mechanical ventilation, as it may improve adherence and comfort. 3. When providing active humidification to patients who are invasively ventilated, it is suggested that the device provide a humidity level between 33 mg H(2)O/L and 44 mg H(2)O/L  and gas temperature between 34°C and 41°C at the circuit Y-piece, with a relative humidity of 100%. 4. When providing passive humidification to patients undergoing invasive mechanical ventilation, it is suggested that the HME provide a minimum of 30 mg H(2)O/L. 5. Passive  humidification is not recommended for noninvasive mechanical ventilation. 6. When providing humidification to patients with low tidal volumes, such as when lung-protective ventilation strategies are used, HMEs are not recommended because they contribute additional dead space, which can increase  the ventilation requirement and P(aCO(2)). 7. It is suggested that HMEs are not used as a prevention strategy for ventilator-associated pneumonia.
authors.affiliation: Department of Respiratory Care, The University of Texas Health Sciences Center at San Antonio, San Antonio, Texas 78229, USA. restrepor@uthscsa.edu
authors.forename: Ruben D
authors.initials: RD
authors.lastname: Restrepo
authors.forename: Brian K
authors.initials: BK
authors.lastname: Walsh
mesh_terms: D003422:Critical Care; D006801:Humans; D006813:Humidity; D018579:Patient Selection; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013227:Steam; D013990:Tidal Volume
chemical_list: D013227:Steam