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Face Mask Oxygen is utilized when patients require higher levels of oxygen than traditional low-flow nasal cannula are able to deliver. These higher flow rates can overwhelm the nasal mucosa however, which causes drying of the upper airway, reducing patient comfort and tolerance to treatment especially with un-humidified or poorly humidified oxygen.1 The addition of Essential Humidity (31 °C, 32 mg/L) can provide significant benefits for both caregiver and patient, and plays an important role in restoring natural balance to the state of the patient’s lungs.2 3 |
Enhancing traditional oxygen therapy for improved patient tolerance
Humidification is one of the only mechanisms available to improve patient tolerance with Face Mask Oxygen. Conditioning the gas flow to the Essential level of humidity (31 °C, 32 mg/L) mimics the natural level of humidity found normally in the nasopharynx.
2 While bubble-through humidifiers have been utilized in the past, evidence indicates that significantly greater patient tolerance can be achieved with heated humidification.
1 3
Heated Humidification significantly decreased
the discomfort associated with mouth and
throat dryness when compared with
Bubble Humidification in 30 critically ill patients.
Adapted from Chanques et al. (2009)1
PATIENT NEEDS AND OPTIMAL OUTCOMES
As most clinicians will be aware, patients using face masks can be difficult to manage. This can often be a direct result of poor patient comfort and mask tolerance.
Contributing to this discomfort is the cold, dry oxygen often at high flows that project onto the patient’s face and into the upper airway, provoking dryness of the mouth, nose, throat and respiratory tract.1 While often very
time consuming for the clinician, the likelihood of treatment success for the patient can be reduced due to frequent therapy interruption. To improve continuity of treatment, patient comfort must be enhanced. By using heated humidification, uncomfortable symptoms associated with dryness of the mouth and throat, such as difficulty clearing secretions and swallowing, can be significantly reduced.1
Coupled with patient tolerance is the need to maintain the mucociliary transport system. Drying of the respiratory tract resulting from poorly humidified gas can compromise mucociliary clearance and increase airway resistance. Delivering Essential Humidity can therefore maintain the mucociliary transport system, ensuring secretions remain mobile and airway resistance is minimized.3
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BENEFITS OF FACE MASK OXYGEN WITH ESSENTIAL HUMIDITY
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PATIENT
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CLINICIAN
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| Reduced drying of the upper airway leading to improved patient tolerance1 |
Less attendance time refitting face masks
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Airway resistance is minimized which may reduce work of breathing3 4
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Continuity of treatment due to better patient tolerance may improve likelihood of treatment success
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| Secretions remain mobile and easy to remove |
Simpler chest physiotherapy, facilitating expectoration of secretions
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Easier to swallow
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Easier oral care, maintaining the moisture in the oral mucosa |
1. Chanques G, Constantin J-M, Sauter M, Jung B, Sebbane M, Verzilli D et al. Discomfort associated with underhumidified high-flow oxygen therapy in critically ill patients. Intensive Care Med 2009; 35:996-1003.
2. Primiano FP Jr, Saidel GM, Montague FW Jr, Kruse KL, Green CG, Horowitz JG. Water vapor and temperature dynamics in the upper airways of normal and CF subjects. Eur Respir J 1988; 1(5):407-14.
3. Tuggey JM, Delmastro M, Elliott MW. The effect of mouth leak and humidification during nasal non-invasive ventilation. Respir Med 2007.
4. Moloney E, O’Sullivan S, Hogan T, Poulter LW, Burke CM. Airway dehydration: a therapeutic target in asthma? Chest 2002; 121(6):1806-11.