Humidify low flow oxygen? - page 2
by RunningWithScissors 5,401 Views | 25 Comments
This subject has not been addressed here for several years; there have been several published studies showing no benefit to applying humidification to flow rates less than 5L/min on the nasal cannula; however, I notice that, at... Read More
- 0Feb 21, '07 by RunningWithScissorsHere are 2 of the links to the evidence against humidification (wow, now I see why it is so hard to change practice habits!!!)
[Is it necessary to humidify inhaled low-flow oxygen or low-concentration oxygen?]
To the above RRT poster, please note an excerpt from the abstract:
"in Europe and North America, oxygen is not humidified as long as the oxygen flow is less than 4-5 L/min, according to the guidelines for oxygen therapy announced by the ACCP-NHLBI in 1984 and by AARC in 1992.
Subjective effects of humidification of oxygen for delivery by nasal cannula. A prospective study.
http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=AbstractLast edit by RunningWithScissors on Feb 21, '07
- 0Feb 21, '07 by AliRaeI don't know if our adult hospital does it, but we humidify everything in our children's hospital- even as little as 0.25 litres. That being said, I'm going to go back and read those articles now. Thanks! =)
EDIT: Okay, so I couldn't get to the articles themselves, but I was interested in something that seemed contradictory in the first abstract. It seemed that the researchers were suggesting an increase in the overall humidity of the room as compensation for dryness from the O2. Then, in the last sentence, they stated that the humidity in the room was sufficient. Is this point clearer in the article itself? We have no control over the humidity of our rooms, so if that were the basis for not humidifying O2 via NC, I would just keep on hooking up my bubblers.Last edit by AliRae on Feb 21, '07 : Reason: more info
- 0Feb 23, '07 by KIANThe only benefit to humidify low flow oxygen would be the subjective one by the patient. "It doesn't feel as dry with it on". I do not know if studies would show an increase in nosocomial infections in patients who use bubble humidifiers or not. The bubble humidifiers would be an extra cost to the hospital. If it makes a patient feel better and doesn't hurt them, I guess the only question would be is it "worth" it. I think this would be a small price to pay for someones comfort.
- 0I was on 4LPM during most of my stay and humidification gets MY vote -I have bad sinuses to begin with, and the dry air is murder on 'em. NATURAL air is humidified. And I can't argue against Aviators' comments either.
If I have a patient on continuous O2, even low-flow, I request a humidification unit from Respiratory.
- 0Feb 23, '07 by AliRaeQuote from RunningWithScissorsThanks ... will do! (I think I can actually get a code from my work to get on that whole system ... I need to look into that.)Ali, click on the "related articles" link on the right of the abstracts for more pediatric related articles, I think you will find them useful!
- 0Feb 23, '07 by KellieNurse06I was reading this discussion and wow....very interesting indeed!
I also have found....I don't know if anyone else has noticed......
humidified oxygen tends to be dispersed into a lower concentration as well due to the moisture than what it actually is set at....so some patients tend to have lower 02 readings than when on straight dry oxygen........and people have argued with me on length of 02 tubing as well affecting the readings/amount being absorbed.....I have personally seen both of these effect 02 saturation readings.
I have heard the old ...."1L is 1L" when I asked respiratory people this...and I beg to differ on it......... actuallymy daughter is on 02 as a matter of fact and if she is on humidified 02...her sats drop ......put her on dry 02 they stay up.......it's really strange...but I have noticed this occasionally on other people as well ...so I know it's not me .......has anyone else ever seen this??????? Just curious.....
- 0can't say I've ever seen that. I'd make sure that condensation hadn't pooled in the hose or tube to the point that it was restricting airflow, but otherwise 1L should truly be 1L -the flowmeter (little marble) should read what is actually flowing INTO the humidification unit -it doesn't read the output, only whats coming out of the wall into the tube or bottle. So if you're seeing 2L, and you aren't GETTING 2L, then check your connections because you're losing air somewhere. But if air is flowing 2lpm, then 2lpm is what you're getting. Sat drops don't make sense if you're getting the same amount of air at the end of the cannula. I'd be willing to bet that the humidifier isn't connected tighly to the O2, and possibly the air hose (cannula) isn't connected tightly to the output on the humidifier.
The ONLY way your argument should hold water (2L isn't really 2L) would be if you were measuring the output from the humidifier instead of whats going INTO it. The reasons THAT would read higher than true is becuse the humidified air would be denser than non-humidified air, and that would affect the given measurement -but since you measure the flow before the bottle, that is not the case.
- 0good lord, just what good is a half a liter per minute? Is that a joke?
Good point on the portable O2. My grandfather had O2 at home -a big M tank for 'emergency' (when power failed) that had a humidifier on it, and his usual o2 generator that ran on house power which had a humidifier on it (though he never seemed to get the idea that you have to change the water in the thing, and keep it CLEAN -preferably with distilled water, and change out the unit itself. I'd have loved to have taken a culture sample from that thing.