Heated air humidification vs. cold air nebulisation in tracheotomised patients increases cilia beat frequency in tracheal epithelium and reduces frequency of suctioning procedures

Following tracheotomy the airways lack a mechanism of warming and humidifying the inspired air. Nebulization of saline is a common clinical practice to prevent desiccation of airways. The aim of the study was to compare cold-air-nebulization (CAN) and heated humidification (HH) on cilia activity and the necessary healthcare support. Method: Tracheotomised patients (n=19) were randomized to conventional CAN with a jet nebulizer as a control or HH (T 37 C, RH 100%) with high flow of air (30 L/min) delivered with the AIRVO2 blower-humidifier (Fu0026P Healthcare, NZ). The ciliary beat frequency (CBF) in tracheal epithelial cells was measured in vitro using videomicroscopy on day 2, 4, 6, 8 and 10 following the tracheotomy. Number of suctioning procedures per day to clean the trachea from the excessive mucus was assessed. Results: Data are medians (range). CBF was significantly (pu003c0.001) higher in the HH group 5,9 (14,2) Hz compared to the CAN group 3,9 (10,5) Hz. Differences in CBF were statistically significant (p Conclusion: Results indicate a potential advantage of hydration with heated humidified air over the conventional nebulization of cold saline in the first 10 days following tracheotomy.