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External heated humidification during non-invasive ventilation set up: results from a pilot cross-over clinical trial

Swapna Mandal, Michelle Ramsay, Eui-Sik Suh, Rachel Harding, April Thompson, Abdel Douiri, John Moxham, Patrick Brian Murphy, Nicholas Hart
European Respiratory Journal 2020 55: 1901126; DOI: 10.1183/13993003.01126-2019
Swapna Mandal
1Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas’ Hospital, King's Health Partners, London, UK
2King's College London, School of Life Sciences, Centre for Human and Applied Physiological, London, UK
3Lane Fox Respiratory Service, Guy's and St Thomas’ NHS Foundation Trust, London, UK
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Michelle Ramsay
1Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas’ Hospital, King's Health Partners, London, UK
2King's College London, School of Life Sciences, Centre for Human and Applied Physiological, London, UK
3Lane Fox Respiratory Service, Guy's and St Thomas’ NHS Foundation Trust, London, UK
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Eui-Sik Suh
1Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas’ Hospital, King's Health Partners, London, UK
2King's College London, School of Life Sciences, Centre for Human and Applied Physiological, London, UK
3Lane Fox Respiratory Service, Guy's and St Thomas’ NHS Foundation Trust, London, UK
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Rachel Harding
1Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas’ Hospital, King's Health Partners, London, UK
2King's College London, School of Life Sciences, Centre for Human and Applied Physiological, London, UK
3Lane Fox Respiratory Service, Guy's and St Thomas’ NHS Foundation Trust, London, UK
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April Thompson
1Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas’ Hospital, King's Health Partners, London, UK
2King's College London, School of Life Sciences, Centre for Human and Applied Physiological, London, UK
3Lane Fox Respiratory Service, Guy's and St Thomas’ NHS Foundation Trust, London, UK
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Abdel Douiri
4School of Population Health and Environmental Sciences, King's College London, London, UK
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John Moxham
2King's College London, School of Life Sciences, Centre for Human and Applied Physiological, London, UK
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Patrick Brian Murphy
1Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas’ Hospital, King's Health Partners, London, UK
2King's College London, School of Life Sciences, Centre for Human and Applied Physiological, London, UK
3Lane Fox Respiratory Service, Guy's and St Thomas’ NHS Foundation Trust, London, UK
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Nicholas Hart
1Lane Fox Clinical Respiratory Physiology Research Centre, St Thomas’ Hospital, King's Health Partners, London, UK
2King's College London, School of Life Sciences, Centre for Human and Applied Physiological, London, UK
3Lane Fox Respiratory Service, Guy's and St Thomas’ NHS Foundation Trust, London, UK
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  • ORCID record for Nicholas Hart
  • For correspondence: nicholas.hart@gstt.nhs.uk
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Extract

Patient comfort is important in ensuring adherence to domiciliary non-invasive ventilation (NIV). Oronasal dryness is often reported with NIV use [1], but the use of heated humidification in clinical practice is not uniform [2]. As there are limited data to currently guide clinical practice, we investigated the effect of external heated humidification on neural respiratory drive (NRD), patient–ventilator asynchrony (PVA), patient-reported outcomes, ventilator performance and adherence in a pilot randomised crossover trial in patients with chronic respiratory failure during NIV set up.

Abstract

Short-term heated humidification has limited effect on physiological and clinical outcomes during non-invasive ventilation set up http://bit.ly/31cFfGt

Acknowledgements

A. Douiri and N. Hart acknowledge the support of the National Institute for Health Research (NIHR) Clinical Research Facility at Guy's and St Thomas' NHS Foundation Trust and NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Footnotes

  • This study was registered at www.ClinicalTrials.gov with identifier number NCT01372072.

  • Conflict of interest: S. Mandal reports grants from Fisher and Paykel, during the conduct of the study.

  • Conflict of interest: M. Ramsay has nothing to disclose.

  • Conflict of interest: E-S. Suh has nothing to disclose.

  • Conflict of interest: R. Harding has nothing to disclose.

  • Conflict of interest: A. Thompson has nothing to disclose.

  • Conflict of interest: A. Douiri reports grants from Philips-Respironics, outside the submitted work.

  • Conflict of interest: J. Moxham has nothing to disclose.

  • Conflict of interest: P.B. Murphy reports grants and non-financial support (equipment) from Fischer and Paykel, during the conduct of the study; grants and personal fees for lectures from Philips, Breas, ResMed, and Fischer and Paykel, outside the submitted work.

  • Conflict of interest: N. Hart reports unrestricted grants from Fisher Paykel within the direct area of work commented on here with the funds held and managed by Guy's and St Thomas’ NHS Foundation Trust; N. Hart reports unrestricted grants from Philips and Resmed outside the direct area of work commented on here with the funds held and managed by Guy's and St Thomas’ NHS Foundation Trust; financial support from Philips for development of the MYOTRACE technology that has patent filed in Europe (US pending) outside the area of work commented on here; personal fees for lecturing from Philips-Respironics, Philips, Resmed, Fisher-Paykel both within and outside the area of work commented on here; and N. Hart is on the Pulmonary Research Advisory Board for Philips outside the area of work commented on here, with the funds for this role held by Guy's and St Thomas’ NHS Foundation Trust.

  • Support statement: This study was funded by an unrestricted grant from Fisher and Paykel. Funding information for this article has been deposited with the Crossref Funder Registry.

  • Received June 16, 2019.
  • Accepted January 25, 2020.
  • Copyright ©ERS 2020
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External heated humidification during non-invasive ventilation set up: results from a pilot cross-over clinical trial
Swapna Mandal, Michelle Ramsay, Eui-Sik Suh, Rachel Harding, April Thompson, Abdel Douiri, John Moxham, Patrick Brian Murphy, Nicholas Hart
European Respiratory Journal May 2020, 55 (5) 1901126; DOI: 10.1183/13993003.01126-2019

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External heated humidification during non-invasive ventilation set up: results from a pilot cross-over clinical trial
Swapna Mandal, Michelle Ramsay, Eui-Sik Suh, Rachel Harding, April Thompson, Abdel Douiri, John Moxham, Patrick Brian Murphy, Nicholas Hart
European Respiratory Journal May 2020, 55 (5) 1901126; DOI: 10.1183/13993003.01126-2019
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