Overview

This study compares the effects of two primary airway humidification methods-active heated humidifiers (HHs) and passive heat-and-moisture exchangers (HMEs)-on trauma intensive care unit (ICU) patients requiring prolonged mechanical ventilation. Adequate humidification is essential during mechanical ventilation because artificial airways bypass the body's natural ability to warm and moisten inhaled air. While existing guidelines show no overall superiority of one method over the other in general ICU populations, trauma patients present unique challenges, such as thick or bloody secretions, which may lead to airway obstructions and affect the performance of these devices.

The main purpose of this randomized controlled trial is to evaluate how active versus passive humidification impacts airway complications (such as secretion viscosity and tube obstruction) and clinical outcomes (including ventilator-associated pneumonia, duration of mechanical ventilation, length of ICU stay, and mortality rates). A total of 162 adult trauma patients at Assiut University Hospital will be randomly assigned to either the HH group or the HME group to determine if there are significant clinical differences between the two methods in this specific patient population.

Eligibility

Inclusion Criteria

1. Adult age 18-65 years.
2. Trauma ICU patients receiving invasive mechanical ventilation.
3. Anticipated to require prolonged mechanical ventilation, defined as ≥7 days of invasive ventilatory support

Exclusion Criteria:

1. Immunosuppression such as HIV, cancer or AIDS.
2. Blood leukocyte count \<1,000 cells/mm3.
3. Withdrawal of life-sustaining treatment within 5 days.
4. Use of HME in conjunction with an HH.
5. Contraindications of HME including body temperature \< 32°C, copious, thick, or bloody secretions, significant air leak (exhaled VT \>70% of VT inspired) or broncopleural fistula