• Gustavo A Plotnikow, Darío Villalba, Emiliano Gogniat, Corina Quiroga, Eliana Pérez Calvo, and José Luis Scapellato.
• Division of Physical Therapy and Respiratory Care, Intensive Care Unit, Anchorena Hospital, Buenos Aires City, Buenos Aires, Argentina. gplotnikow@gmail.com.
• Respir Care. 2020 Sep 1; 65 (9): 1250-1257.

BackgroundWe sought to evaluate the performance in terms of absolute humidity (AH), relative humidity (RH), and temperature of different heated humidifiers (HH) and circuits that are commonly used to deliver high-flow oxygen therapy in conventional ranges (30-60 L/min) and unconventional ranges (70-100 L/min).MethodsIn this prospective, observational study, an electronic thermohygrometer was used to obtain the required measurements. A mechanical ventilator was used as a source for high-flow nasal cannula oxygen therapy. For active humidification, the following equipment was used: a HH with standard disposable water trap circuit, 3 servo-controlled HH, and 7 circuits with a heated wire. Data on environmental conditions (ie, temperature, RH, AH) were collected from the laboratory during each measurement; the temperature, RH, and AH resulting from the application of 8 flows (30-100 L/min) were also recorded. Variables were compared with analysis of variance for repeated measurements with Tukey post hoc tests. A value of P < .05 was assumed to be significant.ResultsDuring the study, a statistically significant difference was found in the average AH for each flow for the different devices (P < .005). The highest AH values were recorded with the Fisher & Paykel MR850 and the Medtronic-DAR circuit (AH = 40.8 mg/L with flow of 50 L/min, P < .005), and the lowest AH values were recorded with the Flexicare FL9000 HH and the Flexicare circuit (AH = 11.4 mg/L with 100 L/min flow, P < .005). For flows > 50 L/min, the best performance for all flows in terms of AH was found with the Fisher & Paykel MR850 HH, regardless of the circuit used.ConclusionsDuring oxygen therapy with very high gas flows, HH devices behave differently and in many cases are inefficient in delivering adequate humidification, even at conventional flows. Caution is therefore recommended when selecting the device and flow settings for the implementation of high-flow nasal cannula oxygen therapy.Copyright © 2020 by Daedalus Enterprises.

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