Ventilator Weaning & Decannulation2019-02-21T02:52:32-05:00

Help your patients go home faster

Vapotherm humidification mobilizes secretions to improve airway clearance for tracheostomy patients. Although individual results may vary, data collected by Vapotherm’s LTACH Centers of Excellence suggests that Vapotherm’s humidification may accelerate ventilator weaning and decannulation.

See how one facility reduced their days to wean

Humidification Matters

Humidification matters

As humidification decreases, the mucociliary escalator moves more slowly, or stops completely. In tracheostomy patients, this may cause mucous plugging and other complications.

Humidification parabola
Williams, RB. Respir Care Clin N Am 1998 Jun; 4 (2): 215-28
Vapotherm Humidification

Vapotherm humidification

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
Cool Mist Humidification

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.

Secretion Mobilization
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.
Passover Heated Humidification

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.

Average absolute humidity
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 trials.11. 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.2013.159Read Full Text Although individual results may vary, data collected by Vapotherm's LTACH Centers of Excellence suggests that days to wean may be reduced if patients move straight from the vent to Vapotherm.

If pressure support is required as an intermediate step in the weaning protocol, Vapotherm can still be incorporated to provide humidification during vent liberation to improve the likelihood of weaning success.

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.

Hi-VNI for Capping Trials

Use Hi-VNI During Capping Trials

When a patient undergoes capping trials at Landmark Hospital of Southwest Florida, the facility switches to the nasal cannula application, or Vapotherm Hi-VNI.

Landmark Hospital of Southwest Florida reported that the humidification and respiratory support helps stimulate the upper airway to improve decannulation success.

The information and testimonials presented in these sections derive from the exerpience of Landmark Hospital of Naples, Florida. Although individual results may vary, Vapotherm believes Landmark’s experiences represent a powerful example of the impact Vapotherm’s humidification can have in an LTACH.
Clinical Outcome
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 in case 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.

Hospital’s Outcome

A Hospital’s Outcome after Vapotherm Standardization

After standardizing to Vapotherm Gaylord Hospital in Wallingford, CT saw the following outcomes between 2011 and 2012.

The information, data, and testimonials presented in this section derive from the experience of Gaylord Hospital in Connecticut. Although individual results may vary, Vapotherm believes Gaylord’s story represents a powerful example of the impact Vapotherm’s humidification can have in an LTACH setting.
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