A comparative evaluation of three common airway humidification methods for patients with severe traumatic brain injury

Background: Airway humidification methods are commonly used in clinical practice, but no clear consensus exists on which particular method is best suited for specific clinical conditions. Methods: In this retrospective study, we carried out a quantitative evaluation of three methods commonly used for patients with severe traumatic brain injury (STBI). We recruited 150 patients who received airway humidification after tracheotomy. Subjects were divided into three groups according to the humidification method they received which included oxygen atomizer (OA) group, heat and moisture exchangers (HMEs) group, and heated humidifiers (HHs) group. Variables including phlegm viscosity, humidification effects, phlegm formation rates, daily sputum inhalation times, airway spasm, secondary lung infections, daily nursing load, and evaluation of nurse job satisfaction levels were documented. Results: Results indicated that the OA tended to cause either insufficient or excessive humidification, whereas phlegm scab formation was significantly reduced in HHs. HMEs and HHs displayed equal humidification effects, and a similar daily sputum induction and consequent nursing load. Airway spasm was a frequent occurrence in OA. The severity, but not the infection ratio, of secondary infection decreased significantly in HHs by the 30th day. The OA significantly reduced nursing load, but demonstrated the worst humidification effects. Conclusions: Overall results suggested that the HHs is more suitable for airway nursing of STBI patients who are bedridden for extended periods.