What is the difference between high-flow and Vapotherm?
While common HFNC uses large bore cannulas, Vapotherm high velocity therapy uses a small bore cannula system. By generating high velocity, this therapy flushes the upper airway dead space faster than common HFNC.
Is Vapotherm heated high-flow?
Vapotherm high velocity therapy is Mask-Free NIV® for spontaneously breathing patients and as such a viable alternative to NiPPV (e.g. BiPAP®). Unlike pressure-based respiratory support modalities, it achieves oxygenation and ventilatory support through a high velocity flush of the patient's end-expiratory gas.
What is considered high flow oxygen?
High-flow nasal cannula (HFNC) therapy is an oxygen supply system capable of delivering up to 100% humidified and heated oxygen at a flow rate of up to 60 liters per minute.
How much oxygen does Vapotherm deliver?
The flow rates may be from 1 to 40 liters per minute via nasal cannula.
Is Vapotherm positive pressure?
New Analysis Suggests Vapotherm High Velocity Therapy May Be as Effective as Noninvasive Positive Pressure Ventilation (NiPPV) Among Studied Hypercapnic Patients.
What is the difference between Optiflow and Vapotherm?
Images courtesy Fisher & Paykel Healthcare and Vapotherm. A: Optiflow nasal prongs and inspiratory circuit are both large bore. Flow is delivered from one side only. B: The high-velocity nasal insufflation (Hi-VNI) system (Vapotherm) uses a slender nasal cannula similar in appearance to a regular nasal oxygen cannula.
Is non-rebreather considered high flow?
Non-rebreather masks are used to deliver oxygen therapy to people who require high-concentration oxygen but aren't in need of breathing assistance. They're considered low-flow oxygen delivery systems.
What's the difference between high flow and low flow oxygen?
Low-flow systems often are more comfortable, but the ability to deliver a precise oxygen concentration in various respiratory breathing patterns is limited. A high-flow system can deliver very accurate oxygen concentrations, but is often uncomfortable and obtrusive.
Is non-rebreather high or low flow?
The authors have used nonrebreather masks, which are low-flow oxygen delivery systems that generally provide oxygen at flow rates lower than the patient's inspiratory demands.
How many liters can Vapotherm go up to?
While clinicians should titrate flow to clinical effect, Vapotherm high velocity therapy generally achieves clinical efficacy between 25-35 L/min in adults and 6-8 L/min in neonates and for pediatric patients it is recommended to set the flow at 1.5-2 L/min per kilogram of bodyweight, up to 8kg.
How does Vapotherm work?
7:0210:36Vapotherm Precision Flow | In Service Video | Customer Training and ...YouTubeStart of suggested clipEnd of suggested clipSimply push the centre blue knob until the item you wish to adjust flashes. Once the fio2MoreSimply push the centre blue knob until the item you wish to adjust flashes. Once the fio2 temperature or flow field flashes. Then you can turn the knob to your desired setting.
Is Vapotherm the same as CPAP?
Evidence from these clinical trials suggests Vapotherm high velocity therapy is the only mask-free form of non-invasive ventilation for spontaneously breathing patients shown to be as clinically effective as CPAP/Bi-Level and NiPPV as a tool for primary non-invasive management of preterm infants with RDS.
Is 6 liters of oxygen considered high flow?
Continuous flows are better for flow rates above 4 liters/minute. There are high-flow stationary concentrators that go up to 10 and 15 liters/minute. For oxygen settings higher than 6 liters/minute, a high flow nasal cannula is needed.
What is the maximum oxygen flow rate for a nasal cannula?
High Flow Oxygen vs. Low flow nasal cannulas can only deliver a nasal cannula flow rate of 4-6 liters of oxygen per minute. They don't provide humidified or heated oxygen. So, they often dry out the nasal passages. This can lead to bleeding or irritation.
Is 10 liters of oxygen a lot?
Some patients only need 1 to 10 liters per minute of supplemental oxygen. But others we have to put on “high flow” oxygen system – 30 liters to 70 liters per minute. That's a lot. It can be very uncomfortable as air will be blown up your nose at a very rapid rate.
What is the minimum flow rate for high-flow nasal cannula?
HFNC is best applied in a monitored setting such as the intensive care unit, intermediate care floor, or emergency department. Oxygen is delivered to the patient through wide bore nasal cannulae (picture 1). We prefer to set the flow rate first, typically at 20 to 35 L/minute (range 5 to 60 L/minute).
How does a vapotherm work?
Vapotherm minimizes rainout via uniformly circulating warmth of the water jacket. One common method is a delivery tube with heated wire circuits. The common downside of this design is that because the tube isn’t heated uniformly, rainout can happen when gas comes into contact with cooler surfaces.
How does gas humidify?
One common method of heating and humidifying gas is through pass-over humidification, where breathing gas passes over highly heated water to add moisture and humidify the gas. Devices using this method use higher than set temperatures in both the creation and maintenance of humidification.
Is HFNC the same as BTT?
Finally, you can also look to FDA product categories to see that not all HFNC devices are the same. Commodity high flow oxygen products are in a respiratory humidifier product category (BTT). However, the FDA recently created a new category which includes a product that uses high velocity nasal insufflation and has a label that states the product can be used to augment breathing in spontaneously breathing patients suffering from respiratory distress in a hospital setting. At the time of publication, Vapotherm’s Precision Flow Hi-VNI ™ system is the only device placed in this FDA category.
Is HFNC more effective than oxygen?
The general consensus about HFNC is that it is often viewed as an option that is more effective than standard oxygen therapy among hypoxemic patients and also more comfortable when compared to mask-based noninvasive ventilation (NIV). [1] . In the 2018 article A Systematic Review of the High-flow Nasal Cannula for Adult Patients, ...
What is the difference between high velocity oxygen and commodity oxygen?
High velocity therapy and commodity high flow oxygen products have similar goals when it comes to maintaining patient comfort and tolerance while delivering respiratory support. One of the easily spotted differences between the two is the liter flow maximum. However, there is an important, less visible difference in the velocity at which flow is delivered. Understanding the mechanisms behind these differences can also help shed light on the differences in patient outcomes.
How does high velocity therapy help with WOB?
High velocity therapy and WOB reduction: The fact that small-bore cannulas reduce the time required to fully purge the upper airway dead space [3] is significant because as the respiratory rate of a patient in respiratory distress increases, the time between breaths decreases. By quickly clearing the upper airway dead space of end-expiratory gas rich in CO 2, high velocity therapy helps patients breathe directly from a fresh gas reservoir and thereby reduces their WOB.
What is the flow rate of a randomized controlled trial?
As a point of reference, the starting flow rates for respiratory distress in all-comers in the ED from Doshi and colleagues’ randomized controlled trial were 35 L/min. [1] The average flow rate across the trial was 30 L/min.
Why is a higher flow rate important?
A second frequently made assumption is that having higher flow rates could potentially rescue patients presenting with moderate or even severe respiratory distress by more effectively maintaining oxygenation and supporting ventilation via the greater flow volume. However, high velocity therapy and commodity high flow oxygen products don’t deliver flow the same way. There are significant differences that impact patient outcomes.
Is high velocity therapy a tool for treating hypercapnia?
In short, there is evidence that demonstrates that high velocity therapy is a tool for treating undifferentiated respiratory distress, including hypercapnia. There is no evidence to demonstrate this for conventional HFNC devices.
Does it matter how much flow is delivered?
The answer is yes, but it matters just how the flow is delivered. A good analogy is a garden hose. If you have two garden hoses running side by side delivering the exact same volume of flow, their performance would be equivalent.
Does velocity matter?
After all, if one device delivers 25 liters of flow per minute and another device does too, doesn’t the patient receive 25 liters of flow per minute? The answer is yes, but it matters just how the flow is delivered.
Is a vaptherm a high flow system?
Using a high-flow respiratory system (Vapotherm) within a high dependency setting. A non-invasive high-flow respiratory support system can be effective at improving oxygenation in hypoxic patients. Patients were generally satisfied with the system and the system seems suitable for use in an adult surgical high dependency setting.
Is a high flow respiratory system invasive?
A non-invasive high-flow respiratory support system can be effective at improving oxygenation in hypoxic patients. Patients were generally satisfied with the system and the system seems suitable for use in an adult surgical high dependency setting.
What temperature should sterile water be?
Water: Sterile water for inhalation in pre-filled sealed container. Recommended water change interval based on flow rate and operation at 37°C.
How is sterile water connected to the disposable water path?
Sterile water supply is connected to the disposable water path using a standard spike
What is nasal high flow therapy?
7: Nasal High-Flow Therapy as Primary Respiratory Support for Preterm Infants without the Need for Rescue with Nasal Continuous Positive Airway Pressure (Conducted with Vapotherm high velocity therapy) [8]
Is high velocity therapy safe?
There was no significant difference in patient characteristics between the two types of centers. The results suggest that high velocity therapy is an efficacious tool and support that it is a safe tool for routine respiratory management of premature infants.
