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Thomas Weiler, Asavari Kamerkar, Justin Hotz, Patrick A Ross, Christopher J L Newth, Robinder G Khemani
OBJECTIVE: To use an objective metric of effort of breathing to determine optimal high flow nasal cannula (HFNC) flow rates in children <3 years of age. STUDY DESIGN: Single-center prospective trial in a 24-bed pediatric intensive care unit of children <3 years of age on HFNC. We measured the percent change in pressure∙rate product (PRP) (an objective measure of effort of breathing) as a function of weight-indexed flow rates of 0.5, 1.0, 1.5, and 2.0 L/kg/minute...
October 2017: Journal of Pediatrics
Kitty Leung, Christopher J L Newth, Justin C Hotz, Kevin C O'Brien, James B Fink, Allan L Coates
OBJECTIVES: The Vapotherm system delivers high humidity to the airway of patients by using semipermeable tubules where heated liquid water is in contact with air. The humidified air is conducted to the patient via a heated tube. Preliminary clinical observations in infants with croup suggested that epinephrine added to the water supplying the humidity was delivered successfully in the vapor phase. The purpose of this study was to evaluate the efficiency of the delivery of epinephrine in the vapor phase and to develop the feasibility criteria for a clinical pilot study...
April 2016: Pediatric Critical Care Medicine
Calum T Roberts, Rebecca Kortekaas, Jennifer A Dawson, Brett J Manley, Louise S Owen, Peter G Davis
OBJECTIVE: Heating and humidification of inspired gases is routine during neonatal non-invasive respiratory support. However, little is known about the temperature and humidity delivered to the upper airway. The International Standards Organization (ISO) specifies that for all patients with an artificial airway humidifiers should deliver ≥33 g/m(3) absolute humidity (AH). We assessed the oropharyngeal temperature and humidity during different non-invasive support modes in a neonatal manikin study...
May 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Amir Kugelman, Arieh Riskin, Waseem Said, Irit Shoris, Frida Mor, David Bader
OBJECTIVE: To compare the requirement for endotracheal ventilation in preterm infants treated with heated, humidified high-flow nasal cannula (HHHFNC) with those treated with nasal intermittent positive pressure ventilation (NIPPV) for the primary treatment of respiratory distress syndrome (RDS). STUDY DESIGN: Randomized, controlled, prospective, single-center pilot study. Infants (gestational age [GA] <35 weeks, birth weight [BW] >1,000 g) with RDS were randomly assigned to receive HHHFNC (38 infants) delivered by Vapotherm® device (Precision Flow™ or 2000 i, Vapotherm Inc...
June 2015: Pediatric Pulmonology
C L Collins, C Barfield, R S C Horne, P G Davis
UNLABELLED: The objectives of this study were (1) to devise a nasal trauma score for preterm infants receiving non-invasive respiratory support, (2) to compare the incidence of nasal trauma in preterm infants <32 weeks gestation randomised to either nasal continuous positive airway pressure (NCPAP) or heated humidified high-Flow nasal cannulae (HHHFNC), in the first 7 days post-extubation and (3) to assess the effect of two different nasal dressings in those assigned to NCPAP. We randomly assigned preterm ventilated infants to receive Vapotherm® HHHFNC or NCPAP post-extubation...
February 2014: European Journal of Pediatrics
Clare L Collins, James R Holberton, Kai König
AIMS: This study aims to determine if there is a difference in the pharyngeal pressure, measured as a surrogate for continuous positive distending airway pressure, delivered to premature infants between two commonly used heated, humidified high-flow nasal cannulae (HHHFNC) devices: Fisher & Paykel Healthcare HHHFNC and Vapotherm 2000i. METHODS: Pharyngeal pressure measurements were taken from stable premature infants receiving HHHFNC for respiratory support...
July 2013: Journal of Paediatrics and Child Health
Shikha Gupta, Aliya Noor, Homer Twigg
SESSION TYPE: Miscellaneous Cases IIPRESENTED ON: Tuesday, October 23, 2012 at 11:15 AM - 12:30 PMINTRODUCTION: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Nonchemotherapeutic (bland) transarterial embolization (TAE) is one of the treatment options for unresectable HCC. We describe a case of hypoxemia after TAE likely due to embolization of microspheres to pulmonary circulation.CASE PRESENTATION: A 76 year old white male presented for bland TAE of HCC, measuring 7.7 x 6.9 cms...
October 1, 2012: Chest
Sarah A Perry, Kenneth C Kesser, David E Geller, Dawn M Selhorst, John K Rendle, James H Hertzog
OBJECTIVE: We investigated the in vitro inspired dose and particle size distribution of albuterol delivered by a vibrating mesh nebulizer through the Vapotherm (Stevensville, MD) humidified high-flow nasal cannula system. DESIGN: Albuterol (2.5 mg/3 mL) was delivered by an Aeroneb Solo (Aerogen, Galway, Ireland) nebulizer that was connected via adaptor proximal to the nasal cannula and downstream from the Vapotherm 2000i. Albuterol was collected onto an inspiratory filter mounted to a breath simulator programmed with age-appropriate breathing patterns...
June 2013: Pediatric Critical Care Medicine
Kai König, Ellen L Stock, Melanie Jarvis
BACKGROUND: Excessive ambient noise levels have been identified as a potential risk factor for adverse outcome in very preterm infants. Noise level measurements for continuous positive airway pressure (CPAP) devices demonstrated that these constantly exceed current recommendations. The use of high-flow nasal cannula (HFNC) as an alternative non-invasive ventilation modality has become more popular in recent years in neonatal care. OBJECTIVE: To study noise levels of two HFNC devices commonly used in newborns...
2013: Neonatology
Clare L Collins, James R Holberton, Charles Barfield, Peter G Davis
OBJECTIVE: To determine whether postextubation respiratory support via heated, humidified, high-flow nasal cannulae (HHHFNC) results in a greater proportion of infants younger than 32 weeks' gestation being successfully extubated after a period of endotracheal positive pressure ventilation compared with conventional nasal continuous positive airway pressure (NCPAP). STUDY DESIGN: We randomly assigned preterm ventilated infants to Vapotherm HHHFNC or NCPAP after extubation...
May 2013: Journal of Pediatrics
Shalini Ojha, Eleanor Gridley, Jon Dorling
AIM: Heated humidified high-flow nasal cannula (HHHFNC) oxygen is a relatively new form of respiratory support and is increasing in popularity despite lack of supportive evidence and amid safety concerns. We investigated the prevalence of its use in tertiary neonatal units in the UK. METHOD: Electronic survey. RESULTS: A total of 57 units were contacted and replies received from 44 (77%). HHHFNC was used in 34/44 (77%) units. Vapotherm 2000i and Fisher and Paykel RT329 were the most popular devices...
March 2013: Acta Paediatrica
Jamuna Kumar, Rajesh Hegde, Sunita Maheshwari, Shekar Rao
We report a case of a 3-year-old boy who underwent an arterial switch operation with relief of left ventricular outflow tract obstruction and later presented with recurrent episodes of flash pulmonary edema. High-flow humidified oxygen with positive pressure support (Vapotherm) was used as a treatment modality, thereby avoiding intubation and mechanical ventilation.
July 2009: Annals of Pediatric Cardiology
S M Miller, S A Dowd
OBJECTIVE: To compare the effectiveness of Fisher and Paykel (FP) and Vapotherm (VT) high-flow nasal cannula (HFNC) in preventing reintubation either within 72 h or <7 days after extubation of premature infants. The primary outcome was the rate of extubation failure defined as reintubation within 72 h. Secondary outcomes included reintubation after ≤7 days. STUDY DESIGN: This was a prospective, randomized pilot study comparing the extubation success of 40 infants born between 26 and 29 weeks of gestation...
December 2010: Journal of Perinatology: Official Journal of the California Perinatal Association
Rashed A Hasan, Robert H Habib
OBJECTIVES: Use of high-flow humidified nasal cannulas to deliver continuous positive airway pressure in children is increasing. Data on the relationship between the flow values and the corresponding pressures are limited. The purpose of this experiment was to evaluate the relationship between the device, intraprong, and proximal airway pressures and the flow values in a neonatal/pediatric test lung model, using the Vapotherm 2000i and Fisher-Paykel humidified nasal cannulas devices. METHODS: Using a pediatric size cannula (2-mm inner diameter), we measured the device, intraprong, and proximal airway pressures at random flow values between 0 L/min and 12 L/min with an FIO2 of 0...
January 2011: Pediatric Critical Care Medicine
Morena Armfield, Gill West
Neonatal units in the UK are beginning to use Vapotherm as a means of providing respiratory support. This device reportedly allows the delivery of high flows of gas at body temperature with close to 100 per cent relative humidity. Evidence from the literature and from UK neonatal units suggests that Vapotherm may be an effective and well-tolerated method of providing babies with respiratory support. It has a number of advantages over therapies such as nasal continuous positive airway pressure, including a reduction in the number of ventilator days and reduced nasal trauma...
February 2009: Paediatric Nursing
Ann M Price, Catherine Plowright, Arystarch Makowski, Beata Misztal
BACKGROUND: Vapotherm 2000i is a non-invasive high-flow respiratory support system used mainly in the treatment of type 1 respiratory failure. It uses a mixture of oxygen and air to deliver a set concentration via nasal cannula (or tracheostomy mask). The advantage of this system is the high humidity achieved using the integral heated water system. The system has been used in neonatal practice as a replacement for conventional continuous positive airway pressure (CPAP) but there is little published research within the adult setting about its use...
November 2008: Nursing in Critical Care
Tatjana P Calvano, Joshua M Sill, Kenneth R Kemp, Kevin K Chung
We used a high-flow nasal cannula with a patient who required a high fraction of inspired oxygen but could not tolerate a nasal or facial mask. We saw a 92-year-old woman with delirium and dementia in the intensive care unit for multi-lobar pneumonia with severe hypoxemia. Attempts to oxygenate the patient failed because she was unable to tolerate various facial and nasal masks. We then tried a high-flow nasal cannula (Vapotherm 2000i), which she tolerated well, and she had marked improvement in gas exchange and quality of life...
December 2008: Respiratory Care
M A B Sim, P Dean, J Kinsella, R Black, R Carter, M Hughes
Oxygen is the commonest drug prescribed in hospitals. The inhaled concentration is altered by the administered oxygen flow rate, the characteristics of the delivery device and the patient's respiratory pattern. Using healthy volunteers we measured the inspired oxygen concentration achieved with different devices both at rest and when the breathing pattern of respiratory failure was simulated by binding the subjects' chests until the forced expiratory volume in 1 s was reduced by > 50% and the respiratory rate was > 25 breaths...
September 2008: Anaesthesia
D Holleman-Duray, D Kaupie, M G Weiss
OBJECTIVE: Respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) are frequent complications of prematurity. To decrease ventilator-induced lung injury, we evaluated the safety, efficacy and neonatal outcomes of a heated humidified high-flow nasal cannula (HFNC) system and an early extubation protocol (EEP) designed for preterm infants 25 to 29 weeks' gestational age (GA). STUDY DESIGN: The Vapotherm (VT) high-flow humidification system was introduced to our unit in March 2004...
December 2007: Journal of Perinatology: Official Journal of the California Perinatal Association
Michael A Jhung, Rebecca H Sunenshine, Judith Noble-Wang, Susan E Coffin, Keith St John, Felicia M Lewis, Bette Jensen, Alicia Peterson, John LiPuma, Matthew J Arduino, Galit Holzmann-Pazgal, Jane T Atkins, Arjun Srinivasan
OBJECTIVES: In August 2005, the Centers for Disease Control and Prevention was notified of a Ralstonia species outbreak among pediatric patients receiving supplemental oxygen therapy with the Vapotherm 2000i (Vapotherm, Inc, Stevensville, MD). The Vapotherm 2000i is a reusable medical device that was used in >900 hospitals in the United States in 2005. Ralstonia are waterborne bacilli that have been implicated in hospital-acquired infections. We initiated an investigation to determine the source of the outbreak and implement infection control and prevention measures...
June 2007: Pediatrics
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