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Effect of tubing condensate on non-invasive positive pressure ventilators tested under simulated clinical conditions

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Abstract

Rationale

Water condensate in the humidifier tubing can affect bi-level ventilation by narrowing tube diameter and increasing airflow resistance. We investigated room temperature and tubing type as ways to reduce condensate and its effect on bi-level triggering and pressure delivery. In this bench study, the aim was to test the hypothesis that a relationship exists between room temperature and tubing condensate.

Methods

Using a patient simulator, a Res-med bi-level device was set to 18/8 cm H2O and run for 6 h at room temperatures of 16°C, 18°C and 20°C. The built-in humidifier was set to a low, medium or high setting while using unheated or insulated tubing or replaced with a humidifier using heated tubing. Humidifier output, condensate, mask pressure and triggering delay of the bi-level were measured at 1 and 6 h using an infrared hygrometer, metric weights, Honeywell pressure transducer and TSI pneumotach.

Results

When humidity output exceeded 17.5 mg H2O/L, inspiratory pressure fell by 2–15 cm H2O and triggering was delayed by 0.2–0.9 s. Heating the tubing avoided any such ventilatory effect whereas warmer room temperatures or insulating the tubing were of marginal benefit.

Conclusions

Users of bi-level ventilators need to be aware of this problem and its solution. Bi-level humidifier tubing may need to be heated to ensure correct humidification, pressure delivery and triggering.

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Conflict of Interest

Diana Hart received travel funding from Fisher & Paykel Healthcare.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Middlemore Hospital, Auckland, New Zealand

    Diana Elizabeth Hart

  2. Fisher & Paykel Healthcare, East Tamaki, Auckland, New Zealand

    Mark Forman

  3. Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland, New Zealand

    Diana Elizabeth Hart & Andrew G. Veale

Authors
  1. Diana Elizabeth Hart
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  2. Mark Forman
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  3. Andrew G. Veale
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Corresponding author

Correspondence to Diana Elizabeth Hart.

Additional information

Clinical Trial Registration number N/A

The study was sponsored by Fisher & Paykel Healthcare

Diana E Hart received travel funding from Fisher & Paykel.

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Hart, D.E., Forman, M. & Veale, A.G. Effect of tubing condensate on non-invasive positive pressure ventilators tested under simulated clinical conditions. Sleep Breath 15, 535–541 (2011). https://doi.org/10.1007/s11325-010-0397-5

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  • DOI: https://doi.org/10.1007/s11325-010-0397-5

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