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  • Title: Effect of flow rate, humidifier dome and water volume on maximising heated, humidified gas use for neonatal resuscitation.
    Author: Farley RC, Gibbons K, Jardine LA, Shearman AD.
    Journal: Resuscitation; 2013 Oct; 84(10):1428-32. PubMed ID: 23587751.
    Abstract:
    AIM: Dry, cold gas is used for neonatal resuscitation, contributing to low admission temperatures and exacerbation of lung injury. Recently, a method of heating and humidifying neonatal resuscitation gases has become available. We aimed to determine the optimal flow rate, humidifier chamber and water volume needed to reach 36°C, and near 100% humidity at the patient T-piece in the shortest possible time. METHOD: A T-piece resuscitator was connected via a heated patient circuit to a humidifier chamber. Trials were performed using different gas flow rates (6, 8 and 10L/min), humidification chambers (MR290, MR225) and water volumes (30g, 108g). Temperature was recorded at the humidifier chamber (T1), distal temperature probe (T2) and the T-piece (T3) over a 20min period at 30s intervals. A test lung was added during one trial. RESULTS: No significant difference existed between flow rates 8L/min and 10L/min (p=0.091, p=0.631). T3 reached 36°C and remained stable at 360s (8L/min, MR225, 30mL); near 100% RH was reached at 107s (10L/min, MR225, 30mL). T3 and humidity reached and remained stable at 480s (10L/min, MR290, 30mL). Target temperature and humidity was not reached with the test lung. CONCLUSIONS: It is possible to deliver heated, humidified gases in neonatal resuscitation in a clinically acceptable timeframe. We suggest the set-up to achieve optimal temperature and humidity for resuscitation purposes is 10L/min of gas flow, a MR290 humidification chamber, and 30mL of water.
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