Help Your Patients Go Home Faster.
Vapotherm humidification mobilizes secretions to improve airway clearance for tracheostomy patients, which may accelerate ventilator weaning and decannulation.
As humidification decreases, the mucociliary escalator moves more slowly, or stops completely. In tracheostomy patients, this may cause mucous plugging and other complications.
Williams, RB. Respir Care Clin N Am 1998 Jun; 4 (2): 215-28
Vapotherm uses unique membrane technology to create humidification at .005 microns. Breathing gas travels through the center of the membrane, while warm water diffuses across the membrane. This generates an energetically stable vapor which does not rain out.
As important as humidification creation, is the way that humidification is delivered to the patient. Vapotherm technology uses a triple lumen delivery tube that maintains the vapor all the way to the patient.
Warm water circulates around the outer lumen, while the humidified breathing gas travels through the center lumen. As the water and gas never come in contact with each other, the risk of rain out is eliminated.
*warm water on the outside, vapor humidification on the inside
Differences in Humidification – Cool Mist
The humidification standard for many tracheostomy patients is cool mist. Research has shown that there isn't a significant difference between cool mist and no humidification.
Adapted from: Williams, Robin; Rankin, Nigel; Smith, Tony; Galler, David; Seakins, Paul, Relationship between humidity and temperature of inspired gases and the function of airway mucosa, Critical Medicine. 24(11):1920-1929, November 1996.
Differences in Humidification – Passover Heated Humidification
Passover heated humidification provides better support than cool mist, but still does not achieve the constant medical grade vapor, 100% relative humidity that Vapotherm humidification does. The chart below shows humidification comparison between Vapotherm and passover heated humidification.
In many of these systems, the delivery tube use a heated wire circuit to maintain humidity. This can cause potential for rain-out which may travel to the patient or require additional maintenance for staff.
Waugh JB, Granger WM. An evaluation of 2 new devices for nasal high-flow gas therapy. Respir Care. 2004:49(8):902-6.
Chikata Y, Izawa M, Okuda N, et al. Humidification performance of two high-flow nasal cannula devices: a bench study. Respir Care. 2014;59(8):1186-90.
Go Straight From the Vent to Vapotherm
Research has shown that many weaning tracheostomy patients do not need pressure support (bi-level) as an intermediate step before spontaneous breathing trials1. Days to wean may be reduced if patients move straight from the vent to Vapotherm.
If pressure support is required as part of a protocol, Vapotherm can still be incorporated to improve weaning success.
Jubran A, Grant BJB, Duffner LA, Collins EG, Lanuza DM, Hoffman LA, Tobin MJ. Effect of Pressure Support vs Unassisted Breathing Through a Tracheostomy Collar on Weaning Duration in Patients Requiring Prolonged Mechanical Ventilation A Randomized Trial. JAMA. 2013;309(7):671-677. doi:10.1001/jama.2013.159
Decannulate for Greater Discharge Options
Once a patient is weaned from the vent, there is still significant work to be done for the patient to resume breathing through their upper airway.
Maintaining a patient on Vapotherm through this process may help improve decannulation rates and overall length.
Use Hi-VNI During Capping Trials
When a patient undergoes capping trials, it's time to switch to the nasal cannula application, or Vapotherm Hi-VNI.
Facilities report that the humidification and respiratory support helps "jumpstart" the upper airway to improve decannulation success.
Image Source: Gaylord Hospital, Wallingford, CT.
A Clinical Outcome with Vapotherm
Presentation: An initial X-Ray was taken on arrival. The patient had an open stoma and O2 saturation in the 70s.
Treatment: The trach tube was replaced to facilitate mobilization of secretions and incase the patient needed to return to mechanical ventilation. The staff then administered membrane heated humidification with the Vapotherm Precision Flow.
Results: Five days later, another X-Ray was taken. the humidification mobilized the secretions to clear the patients lung. Other than standard clinical care, the staff did not employ any additional airway clearance mechanisms during this time.
A Hospital’s Outcome after Vapotherm Standardization
After standardizing to Vapotherm Gaylord Hospital in Wallingford, CT saw the following outcomes between 2011 and 2012.