Vapotherm

dawngloves, BSN, RN · Apr 10, 2005

We love it! But we only have one unit. Only have a problem with water shooting up the kiddos noses.

TiffyRN, BSN, PhD · Apr 11, 2005

We just started using them in the last 4-5 months. We really like them in general. Especially for the chronic kids when they are ready to come off the vent. We are having some issues with the micro-preemies getting abd. distention and we think more prone to NEC/perfs.

Previously the only choices for our chronics coming off the vent was NPCPAP which made them madder than heck or high flow NC but the highest flow on that was 2L/min and really dried out their noses and made them bleed.

We have felt all kids on Vapotherm need their OG's left to chimney to vent the extra air that inevitably goes to their stomachs. One minor annoyance is that it's hard to keep their OG's taped (to their upper lip) due to the moisture from their noses.

As for the moisture going up their noses, I do notice some, however I think some of that moisture is beneficial as even the chronic kids don't seem to need to be suctioned and if you do the secretions are very thin and scant. Most of the time bulb suctioning is all that's needed.

Gompers, BSN, RN · Apr 11, 2005

We have felt all kids on Vapotherm need their OG's left to chimney to vent the extra air that inevitably goes to their stomachs. One minor annoyance is that it's hard to keep their OG's taped (to their upper lip) due to the moisture from their noses.
As for the moisture going up their noses, I do notice some, however I think some of that moisture is beneficial as even the chronic kids don't seem to need to be suctioned and if you do the secretions are very thin and scant. Most of the time bulb suctioning is all that's needed.

Good point about the OG tubes. We had a thread about Vapotherm here a few months ago, and that was one of the things I had mentioned. We still have nurses that don't leave the tubes open and the poor kids get horribly distended with painful gas. :uhoh21: The only tape we have found that stays put for at least a day or two is the pink HyTape. It's waterproof and doesn't absorb moisture as much as other tapes. We still have to retape every couple of days, especially if the baby is on >4 LPM of flow, it seems. For kids in isolettes or radiant warmers, try keeping as much of the Vapotherm tubing as possible inside of the heated bed. Our respiratory therapists have found that the reason there is so much condensation is because the tubing is so hot and when the cold air hits it, the humidity turns into straight water instead of staying vaporized. We've found this to really help a lot. For larger babies in open cribs, we find that if we change the air temperature down from 37 degrees to about 35 degrees, this also helps a bit because it decreases the difference in temperature between the tubing and room air.

RN2NNP · Apr 13, 2005

One minor annoyance is that it's hard to keep their OG's taped (to their upper lip) due to the moisture from their noses.
As for the moisture going up their noses, I do notice some, however I think some of that moisture is beneficial as even the chronic kids don't seem to need to be suctioned and if you do the secretions are very thin and scant. Most of the time bulb suctioning is all that's needed.

We have been using vapotherm for almost a year now and we love it. It is a lot better than the NCPAP with the long prongs. Like you said, it definately minimizes the amount of secretions. As far as securing the OGT, why don't you try taping the OGT to the chin. This is what we have been doing since I started working in the NICU and it really seems to work well as the moisture from the vapotherm does not interfere with the adhesive when the OGT is taped to the chin. Just an idea... :idea:

TiffyRN, BSN, PhD · Apr 13, 2005

We have been using vapotherm for almost a year now and we love it. It is a lot better than the NCPAP with the long prongs. Like you said, it definately minimizes the amount of secretions. As far as securing the OGT, why don't you try taping the OGT to the chin. This is what we have been doing since I started working in the NICU and it really seems to work well as the moisture from the vapotherm does not interfere with the adhesive when the OGT is taped to the chin. Just an idea...

We do tape it to their chins sometimes. It's just a matter of all that moisture though, the last couple I had bubbled from their mouths so bad even taping it their was a problem. Some of the chronic kids are very good at tonguing out anthing not taped to the upper lip but chronics always have their special challenges don't they? I wish we had the hy-tape or pink tape, everyone speaks so highly of it. I used to use it when I worked with adult patients and loved it.

barbnicu · Jul 9, 2009

Back to the Vapotherm: does anyone have evidence that the neonates stomach has to be decompressed? Our current practice is: #8OG to low intermittant suction for neonate 1501 grams. Anyone come across any of this?

We have been using Vapotherm since our unit opened in 2005 (with time off when they were recalled), and all of the staff, including Doc, and NNP's love it! We are a small unit, but almost all the staff has Level 3 experience.

I am going to share the input about keeping the tubing warm to keep down the incidence of "showers" for the baby. That is one of the things that cause challenges for us. We also find that if the flow goes below 2.5 lpm, there is more "rainout". What is everyone else doing about that?

Sweeper933 · Jul 12, 2009

Back to the Vapotherm: does anyone have evidence that the neonates stomach has to be decompressed? Our current practice is: #8OG to low intermittant suction for neonate 1501 grams. Anyone come across any of this?
We have been using Vapotherm since our unit opened in 2005 (with time off when they were recalled), and all of the staff, including Doc, and NNP's love it! We are a small unit, but almost all the staff has Level 3 experience.
I am going to share the input about keeping the tubing warm to keep down the incidence of "showers" for the baby. That is one of the things that cause challenges for us. We also find that if the flow goes below 2.5 lpm, there is more "rainout". What is everyone else doing about that?

So if you have babies that are on Vapotherm on low intermittant suction... are you then not feeding them at all while on Vapotherm....????

dawngloves, BSN, RN · Jul 12, 2009

So if you have babies that are on Vapotherm on low intermittant suction... are you then not feeding them at all while on Vapotherm....????

??? :lol2: Interesting!

We have since changed our "high flow nasal cannula" set up and no longer have the problem with water shooting up the kiddos noses.

barbnicu · Jul 13, 2009

We will give trophic feeds, starting with small amts: 1 or 2 mls, through the OG, then leave it open to vent air. How did change your "high flow nasal cannula" set up? Nasal "rinsing" is so irritating to the babies. I am very interested in finding out anything that can make them more comfortable.