Why is humidified oxygen used

Miyamoto K, Nishimura M Nasal dryness discomfort in individuals receiving dry oxygen via nasal cannula. Respir Care — PubMed Google Scholar. A prospective study. Chest — Ann Fr Anesth Reanim — Preliminary results. Google Scholar. Intensive Care Med. PubMed Article Google Scholar. Intensive Care Med S Article Google Scholar. Ricard J-D Humidification. In: Tobin M ed Principles and practice of mechanical ventilation. McGraw-Hill, New York, pp — Intensive Care Med — Download references.

You can also search for this author in PubMed Google Scholar. Correspondence to Jean-Damien Ricard. This editorial refers to the articles available at: doi: Reprints and Permissions. Ricard, JD. Humidification during oxygen therapy and non-invasive ventilation: do we need some and how much?. Intensive Care Med 35, — Download citation.

Received : 06 February Accepted : 07 February Published : 18 March Issue Date : June Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. The BTS suggest using nebulised normal saline in this situation. Specialists starting NIV therapy will assess the severity of symptoms and decide whether to add humidification - usually in the form of a heated humidifier added into the ventilatory circuit to minimise upper airway symptoms.

Patients in the community with humidification must adhere to strict cleaning protocols for the humidifiers to avoid pulmonary infection. In most cases, they must replace any water in the humidified system with cool boiled water every day.

Community teams must help ensure this practice occurs. In most cases low flow oxygen can be safely administered to patients via a mask or nasal cannula without humidification, and humidification should only be considered after a variety of oxygen delivery devices have been used.

Andres D et al Randomised double-blind trial of the effects of humidified compared to nonhumidified low flow oxygen therapy on the symptoms of patients. Canadian Respiratory Journal; 4: 2, Thorax; 63 Suppl 6 Campbell E et al Subjective effects of humidification of oxygen for delivery by nasal cannula.

A prospective study. Chest ; 2, Sign in or Register a new account to join the discussion. An orange traffic light confirms the AIRVO 2 has not been cleaned and disinfected since last use, and is not safe for use on a new patient. Follow the instructions in the disinfection kit manual :. Click to view the delivery mode quick reference table. This system is simple and convenient to use. Simple nasal prongs are available in different sizes. To ensure the patient is able to entrain room air around the nasal prongs and a complete seal is not created the prong size should be approximately half the diameter of the nares.

Select the appropriate size nasal prong for the patient's age and size. For nasal prong oxygen without humidification a maximum flow of:. With the above flow rates humidification is not usually required. However, if humidification is clinically indicated - set up as per the recommended guidelines for the specific equipment used.

As with the other delivery systems the inspired FiO2 depends on the flow rate of oxygen and varies according to the patient's minute ventilation. If the required flow rate exceeds those as recommended above this may result in nasal discomfort and irritation of the mucous membranes. Therefore, humidification of nasal prong oxygen therapy is recommended.

For nasal prong oxygen with humidification a maximum flow of:. Optiflow nasal prongs are compatible for use in humidified low or high flow oxygen delivery. See guide below for recommended patient sizing and flow rates. Fisher and Paykel Optiflow nasal cannula junior range Four sizes of prongs:.

See Appendix A for further information regarding appropriate junior range sizing: Fisher and Paykel Optiflow junior range sizing guide. RT circuit - click here for instructions for use.

This valve has been designed to minimize the risk of excessive pressure being delivered to the infant in the event that the nasal prongs seal around the infant's nares while the mouth is closed.

The image below is of the RT circuit. RT Circuit and O2 stem - click here for instructions for use. High Flow in approved areas only. Optiflow Nasal Prong junior and standard humidification and flow rate guide for Airvo. At RCH both simple face masks in various sizes and tracheostomy masks are available. The minimum flow rate through any face mask or tracheostomy mask is 4 LPM as this prevents the possibility of CO 2 accumulation and CO 2 re-breathing.

Select a mask which best fits from the child's bridge of nose to the cleft of jaw, and adjust the nose clip and head strap to secure in place. Oxygen via intact upper airway via a simple face mask at flow rates of 4LPM does not routinely require humidification. Additionally in some conditions eg. Asthma , the inhalation of dry gases can compound bronchoconstriction. A non-rebreathing face mask has an oxygen reservoir bag and one-way valve system which prevents exhaled gases mixing with fresh gas flow.

The non-rebreathing mask system may also have a valve on the side ports of the mask which prevents entrainment of room air into the mask. While a specific FiO 2 is delivered to the patient the FiO 2 that is actually inspired by the patient ie what the patient actually receives varies depending on:.

At the RCH, oxygen therapy via an isolette is usually only for use in the Butterfly neonatal intensive care unit. See Isolette use in paediatric wards , RCH internal link only. Appendix A - Pediatric sizing guides for nasal prongs. Fisher and Paykel Optiflow junior range sizing guide.

The evidence table for this guideline can be viewed here. Please remember to read the disclaimer. Updated July The Royal Children's Hospital Melbourne. Oxygen delivery.

Oxygen delivery Aim Introduction Definition of terms Normal values and SpO 2 targets Indications for oxygen delivery Nurse initiated oxygen Patient assessment and documentation Weaning oxygen Selecting the delivery method Low flow delivery method High flow delivery method Considerations Links Appendix A - Paediatric sizing guides for nasal prongs Evidence Table References Aim The aim of this guideline is to describe the indications and procedure for the use of oxygen therapy, and its modes of delivery.

Give oxygen therapy in a way which prevents excessive CO 2 accumulation - i. Reduce the work of breathing. Ensure adequate clearance of secretions and limit the adverse events of hypothermia and insensible water loss by use of optimal humidification dependent on mode of oxygen delivery. Maintain efficient and economical use of oxygen. It is used to assess the adequacy of ventilation. PaO 2 : The partial pressure of oxygen in arterial blood.

It is used to assess the adequacy of oxygenation. SaO 2 : Arterial oxygen saturation measured from blood specimen. SpO 2 : Arterial oxygen saturation measured via pulse oximetry. Heat Moisture Exchange HME product : are devices that retain heat and moisture minimizing moisture loss to the patient airway.

High flow : High flow systems are specific devices that deliver the patient's entire ventilatory demand, meeting, or exceeding the patients Peak Inspiratory Flow Rate PIFR , thereby providing an accurate FiO 2. Where the total flow delivered to the patient meets or exceeds their Peak Inspiratory Flow Rate the FiO 2 delivered to the patient will be accurate. High flow in approved areas only. Consult your NUM if unsure.

Humidification is the addition of heat and moisture to a gas. The amount of water vapour that a gas can carry increases with temperature.