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Discussion

Does your unit use Vapotherm?

...and if it does, what do you think about it? Our unit got a few VTs back in February/March, and we've recently got new ones that have the entirely disposable cartridges and tubing. However, some units that we take babies for (due to our level being higher or space) don't do Vapotherm (some have done it and really don't like it), so we tend to hold onto those babies until they're at least in N/C O2, as we don't want them to take a "step back" by going on CPAP in the units that don't use VT.

What do you think about it?

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We stopped using VT a few years back when it was all being recalled d/t infection problems. We have since just used a "high flow cannula" system. Same function as VT but with easier equipment to manage. It's just heated humidified air that we can have as high as 7LPM.

  • Expert

We used it at the last unit I worked at. We rejoiced when the FDA released them after the "scare." We used HFNC and CPAP in their place while they were off-market.

I LOVE them, and miss them dearly, since all we use here is bubble CPAP.

I think that if your goal is to keep them off NCPAP, keep them as long as it takes to get them on NC02.

We use them and I love them. We had the elephant nose Cpap until the FDA released the Vapotherms and I hated those. Those poor babies, it looked so uncomfortable.

Steve, what is bubble Cpap?

We startes using it again this year, thank goodness! Saves their noses and our sanity.

We've been doing great with just our HFNC system. We still use CPAP when needed, but the HFNC really works well for our babies!

It's been so long since we've used vapotherm... how is it different than a HFNC? I forget :-)

  • Expert
We've been doing great with just our HFNC system. We still use CPAP when needed, but the HFNC really works well for our babies!

It's been so long since we've used vapotherm... how is it different than a HFNC? I forget :-)

Basically just a fancy driver unit..... the principle is the same. Heated and humidified high-flow through a cannula. The only difference is that it has an electronic pop-off valve to prevent pneumos. Your rigged HFNCs have them, they are just more rudimentary

  • Expert
We use them and I love them. We had the elephant nose Cpap until the FDA released the Vapotherms and I hated those. Those poor babies, it looked so uncomfortable.

Steve, what is bubble Cpap?

Bubble CPAP is something one of our docs invented 30 years ago, and we use to death in my unit. We use the typical Hudson CPAP prongs with a heater/humidifier which is connected to a flowmeter/blender. We usually run it at 6-8 LPM depending on the size of the baby.

The inspiratory tubing is connected to the heater, and the expiratory tubing is suspended in 5cm of 0.25% acetic acid solution in a 1L bottle. As the infant breathes, the circuit bubbles in the fluid, and the thought is that it creates almost an oscillator-like vibration in the infant's lungs, improving oxygenation and CO2 removal.

It's basically cheap CPAP. Seeing as how we have most of our 75 babies on it, we can't afford all those drivers and vents. They don't require power for transport, etc.....

Steve, you forgot to tell them how it's MAGIC. If you're on 21% FiO2, it doesn't count as BPD, even if you're on it at six months old!

Magic, I tell you!

We use HFNC, bubble CPAP (which everyone hates) and mask/Prong CPAP. All the RT's talk reverently about vapotherm though and wish we had it back. They did bring it back to the peds floor after the scare, but not to us.

We don't use VT, but we've been using HFNC like crazy lately. Overall, I like HFNC, but sometimes the flimsy prongs don't stay in the nares - and if you don't suspend the tubing just right, the kid gets dumped worse than they would with any vent.

  • Author

I guess the picture is pretty similar to the UK with some hospitals not using and some using VT. Our paediatric unit doesn't use them, the the VT salesman was showing all of us the new machine the other day, including the paeds nurses, and he was trying to say how good it'd be for their bronchiolitics (but it doesn't look like it'd be cost effective for them). I'm glad we have it anyway.

We have something called Comfort Flow, which is the HFNC. The kids do so much better on it. Sometimes they are intubated, given Curosurf, and then extubated back to CF. It works very well, we rarely have to use CPAP any more.

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