Humidify low flow oxygen?

SCRN1 · Feb 19, 2007

If patient's c/o dryness, we call respiratory and ask if they can have humidification. Most patients do say it helps.

caliotter3 · Feb 19, 2007

Where I worked the policy was humidification at 4L/min. If the subject of "evidence based practice" would have been brought up to policy makers, it would not have been given serious consideration. They were hard pressed to get people just to show up for work.

tridil2000, MSN, RN · Feb 19, 2007

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 least in my institution, it is a widespread practice and indeed, many nurses are still under the assumption that at 2L/min a bubbler will help relieve a dry nose.
What is your practice and has your institution changed its policy to align with evidence-based practice?

do you feel better with or without a humidifier on in your home?

nuangel1, BSN, RN · Feb 19, 2007

if pt requests humidifier we do it .

cardiacRN2006, ADN, RN · Feb 19, 2007

Every pt I have put one on says it feels better.

RunningWithScissors · Feb 21, 2007

Every pt I have put one on says it feels better.

This may be a placebo effect....I have had many a patient's family request a bubbler for THEIR comfort for low flow oxygen....really, when you read the study results, it only serves to increase cost and has no benefit. Another old habit that just won't die!!!

Reminds me of the alcohol prep discussion on another thread...we do it because we always have and assume it is the proper way it should be done, without realizing there are better ways of doing things!

Elvish, BSN, DNP, RN, NP · Feb 21, 2007

I believe in evidence-based practice, but if my pt is on 2L O2 & c/o dry nose I will request humidification & see if it helps.

aviator411, RN · Feb 21, 2007

As a respiratory therapy student many years ago I was taught to NEVER give dry 02. Any pt whose condition justifies O2 needs the humidity. Adverse effects of dry O2 are probably not going to be immediately recognizable (they may not be recognizable at all) to the pt or staff but moisture is essential for optimal absorbtion of the gas. It isn't just a matter of comfort. Dry gas will not be absorbed as well as with humidification. It's physics, not symptomology.

caliotter3 · Feb 21, 2007

Thanks aviator. I learned something today. Your point makes sense.

RunningWithScissors · Feb 21, 2007

Here 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?]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15007913&dopt=Abstract

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/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3338294&dopt=Abstract

AliRae · Feb 21, 2007

I 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.