The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

THE EFFECTS OF HIGH FLOW NASAL CANNULA ON THE USE OF INVASIVE VENTILATION AND NASAL CPAP IN A LEVEL IIIC NICU.

Chris Lynn, Laura Beckman, Cheryl Burney-Jones; Vanderbilt Children's Hospital, Nashville, TN

Background: High flow, high humidity nasal cannulas (HFNC) are designed to deliver 100% humidity at or near body temperature. A number of manufacturers produce products capable of delivering HFNC. Vapotherm (Vapotherm Inc, Stevensville, MD), was introduced into the level IIIC Neonatal Intensive Care Unit (NICU) at Monroe Carell Jr. Children's Hospital in April, 2005. Vapotherm allows for the delivery of up to 8 liters per minute of blended oxygen flow in the neonatal population. In February of 2006, ten months following the introduction of Vapotherm to the NICU, Vapotherm sent out an official recall letter due to concerns surrounding infections from the organism ralstonia mannitolilytica. Based on the recall letter sent by Vapotherm, all units were removed from service in the NICU. One year later, after resolving the issue surrounding the recall, Vapotherm units were placed back into service. Objective: To determine the effects of high flow, high humidity nasal cannula use on ventilator days and nasal continuous positive airway pressure (NCPAP) days. Method: Data was retrospectively collected for a total of 39 months. Data collection spanned all important event markers from October 2004 thru December 2007 including data before the introduction of Vapotherm. Results: The use of HFNC had no significant effect on the number of ventilator days in the NICU, however, the number of NCPAP days were significantly affected by the use of HFNC. After the initial introduction of Vapotherm in the NICU, NCPAP days dropped by 42%. During the recall, NCPAP days increased by 36%. After infection issues were addressed and devices were placed back into service, NCPAP days decreased by 73%. Other Considerations: The cost for Vapotherm or Aladdin/EME (NCPAP) hardware is comparable at $5,867.92 and $6,350.00 respectively. The disposable supply cost for the Vapotherm is $94.84 and the Aladdin/EME disposable cost is $96.40 per patient. The cost for the ventilator supplies were not reported because ventilator days were not significantly affected by HFNC use. Sponsored Research - None