The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

VENTILATORY AND NON-VENTILATORY USES OF THE TELEFLEX® NEPTUNE™ HUMIDIFIER IN THE NEONATAL INTENSIVE CARE UNIT

Matthew S. Pavlichko1,2, Kissinger Michael1; 1Respiratory Care Services, The Reading Hospital and Medical Center, West Reading, PA; 2NICU, The Reading Hospital and Medical Center, West Reading, PA

Background: Treating the critically ill neonate requires a special attention to detail to optimize patient outcomes; humidification is one of those details. Gases delivered at ambient temperature; with 100% humidity (44mg/L of water vapor) is vital in the respiratory care of all neonates. Heated and humidified delivered gases optimize secretion clearance, stabilize patient temperature, and decrease insensible water loss. The Teleflex Neptune humidifier was investigated to ensure proper humidification for its use in the NICU during ventilatory and non-ventilatory applications. Method: While evaluating the humidifier, it was important to identify the potential uses it would have in the NICU: ventilator and CPAP humidification, high flow nasal cannula, oxygen hood, and blow-by humidity for skin care. The humidifier was placed distal to the patient interface based on manufacturer’s recommendations. The humidifier was set to deliver a temperature of 37C during all applications. The heater-to-patient temperature gradient control on the Neptune was adjusted to minimize condensation within the circuit and patient interface. The experiment measured the relative humidity (RH) and temperature, proximal to the patient, with an Extech Instruments SuperHeat psychrometer. Measurements were taken in a controlled experimental simulation and during patient use. Results: The Neptune, when used in conjunction with the Drager Babylog and Evita, high flow nasal cannula, and oxyhood, demonstrated stable temperatures of 37C at the patient interface. Experimentally and clinically, the Neptune delivered 99.9% RH to the patient as well. The use of blow-by humidity did show some variations due to inability to enclose the patient interface. The blow-by setup with humidifier measured 82.4-92.4% RH experimentally and up to 99% RH during patient use when the flow was directed at the patient. Patient ambient temperature may be the reason the results of the blow-by trial were different experimentally and clinically. A 10% decrease in RH was noted when the blow-by flow was not directed at the infant. Conclusion: The Neptune humidifier, when used properly, will heat and humidify medical gas therapy (ventilatory and non-ventilatory) effectively in the neonatal population. The humidifier is able to deliver 99.9% RH, at 37C, with minimal condensation. This allows the humidifier to be used during many respiratory care therapies in the NICU. Sponsored Research - None

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