Google Scholar. Is humidified better than non-humidified low-flow oxygen therapy? A systematic review and meta-analysis. J Adv Nurs. Fulmer Snider. Arch Intern Med. PubMed Google Scholar. British thoracic society emergency oxygen guideline group, BTS emergency oxygen guideline development group. BTS guideline for oxygen use in adults in healthcare and emergency settings. Miyamoto K, Nishimura M. Nasal dryness discomfort in individuals receiving dry oxygen via nasal cannula.
High-flow oxygen therapy in acute respiratory failure. Design of oxygen delivery systems influences both effectiveness and comfort in adult volunteers. Can J Anesth. Nasopharyngeal oxygen in adult intensive care - lower flows and increased comfort. Anaesth Intensive Care. Nasopharyngeal oxygen NPO as a safe and comfortable alternative to face mask oxygen therapy. Nasal high-flow versus Venturi mask oxygen therapy after extubation.
Effects on oxygenation, comfort, and clinical outcome. The effects of a 2-h trial of high-flow oxygen by nasal cannula versus Venturi mask in immunocompromised patients with hypoxemic acute respiratory failure: a multicenter randomized trial. Crit Care. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. Download references. LaP and AM were responsible for the study design.
LaP contributed to data collection in Angers and coordinated the data collection in all the participating centers, and he is the guarantor of the paper. LaP and LiP had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
FB contributed substantially to the results interpretation and to the manuscript redaction. All authors contributed to the critical revision and approval of the final manuscript. The authors would like to thank the REVA network for opening its doors to nurses and for its support at all steps of this study.
The authors would also like to thank all the professionals of the Research Department of the University Hospital of Angers who participated in the implementation and the conduct of this study.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. You can also search for this author in PubMed Google Scholar. Correspondence to Laurent Poiroux. The Oxyrea item discomfort scale validation process and complementary data of the Oxyrea study. Reprints and Permissions. Poiroux, L. Effect on comfort of administering bubble-humidified or dry oxygen: the Oxyrea non-inferiority randomized study. Intensive Care 8, Download citation.
Received : 11 October Accepted : 11 December Published : 17 December 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. 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.
Clinical observations: Continuous pulse oximetry for 30 minutes post cessation of oxygen therapy If oxygen wean successful perform vital sign observation, intermittent SpO 2 monitoring 30 minutes later, then hourly for 2 hours. Where oxygen weaning is successful, continuous pulse oximetry monitoring may be discontinued. Check on the individual flow meter for where to read the ball i.
Note: Some flow meters may deliver greater than the maximum flow indicated on the flow meter if the ball is set above the highest amount. Use caution when adjusting the flow meter. Oxygen delivery method selected depends on:. Note : Oxygen therapy should not be delayed in the treatment of life threatening hypoxia. Note: In most low flow systems the flow is usually titrated on the oxygen flow meter and recorded in litres per minute LPM.
Where the Airvo2 is used as an oxygen delivery device the flow from this device is independent to the flow of oxygen. Oxygen therapy can be delivered using a low flow or high flow system. All high flow systems require humidification. The type of humidification device selected will depend on the oxygen delivery system in use, and the patient's requirements.
The humidifier should always be placed at a level below the patient's head. Please consult user manuals for any other models in use. Has two modes:.
When commencing therapy on a new patient, ensure the disinfection cycle was performed. 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.
Methods: We performed a comprehensive, systematic meta-analysis of randomized controlled trials on the efficacy of humidified and non-humidified low-flow oxygen therapy.
Results: Twenty-seven randomized controlled trials with a total number of 8, patients were included.
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