Abstract:

Objective: To explore the optimal replacement time of disposable breathing circuit humidification solution in order to reduce the risk of ventilator-associated pneumonia (VAP). Methods: A total of 80 children who underwent mechanical ventilation treatment in the pediatric intensive care unit (PICU) of Dongguan Maternal and Child Health Hospital from January 2023 to August 2024 were selected as research subjects. They were randomly divided into a control group and an observation group, with 40 cases in each group. Both groups were connected to closed humidification devices with disposable breathing circuit and infused sterilized injection water at a constant speed. The control group replaced sterilized injection water every 24 hours, while the observation group replaced it after being used up, with the longest replacement time not exceeding 96 hours. On the 7th day, both groups replaced their ventilator pipelines and humidification tanks routinely. Clinical indicators such as the incidence of VAP, bacterial culture results of different sites (ventilator pipelines, condensate water, humidification solution), ventilator parameters, and mechanical ventilation time were compared between the two groups. Results: The total incidence of VAP in the observation group after treatment was 10.0% (4/40), which was not statistically different from 20.0% (8/40) in the control group (Fisher’s exact probability test, P=0.210); the positive rates of bacterial culture in the observation group for ventilator pipelines, condensate water, and humidification solution were 10.0% (4/40), 7.5% (3/40), and 5.0% (2/40), respectively, which were significantly lower than 50.0% (20/40), 45.0% (18/40), and 40.0% (16/40) in the control group (χ²=15.238, P<0.001; χ²=14.528, P<0.001; χ²=14.050, P<0.001). The average mechanical ventilation time and PICU hospitalization time of the observation group were (8.21±1.90) days and (11.81±2.82) days, respectively, which were not statistically different from (8.51±2.10) days and (12.31±3.01) days in the control group (t=0.662, P=0.510; t=0.773, P=0.442). Conclusion: For children undergoing mechanical ventilation in the PICU, the strategy of replacing disposable breathing circuit humidification solution after being used up does not increase the incidence of VAP and is a safe and effective replacement method.

Key words: Ventilators, mechanical, Respiration, Humidification solution, Pneumonia, ventilator-associated