Invasive ventilation is a mode of respiratory support that replaces spontaneous breathing in neonates and infants, with an artificial airway such as an endotracheal tube.
Delivering heated and humidified gas is widely recommended and practiced during invasive respiratory support of neonates and infants.
However, during invasive ventilation the upper airway is bypassed, along with its natural airway protection and humidification mechanisms; therefore, heating and humidifying gases while this treatment is being delivered is important.1,2
Medical gas is typically cold and dry (≤ 15°C, < 2% Relative Humidity) compared to ambient air (22 °C, 50% Relative Humidity). The delivery of cold, dry gas to the airway is associated with increased water and heat loss, inflammation in the airway epithelium, and an increased risk of airway injury. Insufficient humidification may also impair secretion clearance and increase the risk of airway blockages. These effects are amplified in preterm infants, where a few minutes of ventilation with insufficient humidification has been shown to increase airway resistance, reduce lung compliance, increase the risk of air leaks, and the need for supplemental oxygen delivery.1,2
There are several key benefits associated with humidification.3-6
Delivering heated and humidified gas during respiratory support assists with secretion mobilization and removal.
Infants need energy for growth and development therefore, assisting in thermoregulation can help conserve energy for these tasks.
Humidification is associated with clearance of retained secretions and prevention of airway drying. Adequate humidification during respiratory support may improve patient comfort and therapy tolerance.
The Fisher & Paykel Healthcare Evaqua™ 2 breathing circuits help minimize mobile condensate in the expiratory limb by allowing water vapor to diffuse through the tubing wall.