Increased insensible loss in preterm neonates [with inadequate humidification] and the LENTH AND DIAMETER OF THE RESPIRATORY LIMBS.

[Sutirtha Roy]

Dear Stefan,

Hope you are doing fine. Heartfelt congratulations for amazing grand success of the EBNEO.

I am afraid that today, I am annoying you with a stupid question.

Honestly at first I was not even confident enough to place the topic in our forum. Probably ashamed to acknowledge my invincible ignorance -publicly.

Some how I am bit confused. The problem was simple but when I started to figure it out, got bit uncomfortable –may be for no reason; But then I thought it's better to make it clear the fundamentals from the best person [May be I am having serious problems with my basics].

The problem was framed something like that, tagged with a piece of unnecessary information one might think:

During conventional or HFOV with inadequate humidification, whether the length and diameter of the circuit limbs [beside the problem of increased resistance]have got any effect on the increased insensible loss for the extremely low birth weight babies [due to the poor down regulation of the Aquaporin channels (AQP 1-5)in the upper respiratory tracts related with gestational age] or not?

Please let me know if I made the question clear to you.

I was bit perplexed while facing the same. I truly apologize for the half-dazed expressions of mine.

I am eagerly looking for your kind response.

Warm Regard, Roy.

[Stefan Johansson]

Questions are never stupid, but answers can be

Anyway, I think your question is clever and I do not know the answer... But, I think you are thinking in the right direction, and that ventil circuit can matter. But, I don't know in what direction of the problem, if shorter tubes makes the problem better or worse. My guess it that a shorter circuit is less easy to humidify, and might increase the water loss from the baby (due to insufficient humidication), but whether this is clinically important, I don't really know.

One thing I do know though, we do not change the lenghts of the tubings but use them "as is", as the manufacturer delivers the tubings.

Maybe someone else have a better answer than me.