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Hi flow nasal cannula "rain out"


Guest shesu

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Guest shesu

We've recently begun using hi flow nasal cannulas with the Fisher-Paykel humidification system. I've noticed the water vapor changes to water droplets at times sending small to moderate sized drops of water into the babies nares. Fisher-Paykel recommends using their invasive mode (temp 37 degrees C) for ETT, CPAP and hi flow nasal cannulas. It's been noted that no droplets seem to form at the noninvasive temp (31 degrees C), but this goes against the manufacturers recommendation so we aren't permitted to decrease the temp. Any suggestions/comments regarding this problem are appreciated. I fear the water, unknown amounts at unknown times, could be harmful.

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Hi Shesu,

we have the same problems, even with our CPAP- Systems (Alladin & SIPAP), there is a huge ammount of water in the heated part of the circuit....

We also have drops of water inside the babies noses with our low- Flow nasal cannulas. What i can`t understand is, why the newer Generation of F&P heaters (MR 850) have this two modes (invasive vs non invasive) although the company itself doesn`t recommend the use of the non ivasive mode.....

If one uses the non- invasive mode, the baby will get warmer and more humidified air into his/her lungs as it would get when breathing room air....

Anyway, we have a serious problem with near drowning, which leads to apneas and bradycardias in our newborns and F&P seems to be unable to handle the situation properly....

Regards Norbert

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  • 2 weeks later...

We had an inservice from Fisher & Paykel tonight because we were having the same problem with "rain out." We learned that if the infant is on a radiant warmer then the temp probe must be covered with a reflective wrap. When an infant is in an isolette with an air temp less than 35 degrees C then the remote/ extension tubing must be removed from the setup, and the temp probe must be inside the bed and not be covered with anything (linen). Basically, the cannula must be connected directly to the temp probe port. When an infant is in an isolette with an air temp greater then 35 degrees C then the remote/ extension tubing must be in the setup and the temp probe must be outside the bed. Also check to make sure that the temp probes are completely inserted into the port and that no blue is showing.

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  • 2 weeks later...
Guest capebob

Hello All,

Just one question are your temp probes inside the incubator or outside. I have used both the invasive and non-invasive mode, and have had no trouble with rain out just make sure the probe is outside.

Cheers

Bob

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Guest enaid1

If using the vapotherm system with an infant in an isolette, make sure that you have as much of the vapotherm tubing as possible coiled in the isolette. If too much of the tubing is left outside of the isolette, the cooler ambient temperature outside of the isolette helps to increase formation of condensation!

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Guest shesu
Hello All,

Just one question are your temp probes inside the incubator or outside. I have used both the invasive and non-invasive mode, and have had no trouble with rain out just make sure the probe is outside.

Cheers

Bob

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  • 11 months later...
Guest JoannieO

Hi all, we also have had ongoing problems with condensation in the CPAP tubings. We use Fisher and Paykel Bubble CPAP and are fortunate that they are very responsive to any concerns we have with the system. They are currently trialling a new configuration of tubing and heating wires that will be able to be used with both high flow and CPAP, so hopefully we will have a new improved version before too long. In the meantime, it is again for the nurses to be vigilant about removing condensation from the tubing before it gets as far as the baby - for some babies this is every half hour or so. I will keep the group informed of any new developments as I hear of them.

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Guest shesu
Hi all, we also have had ongoing problems with condensation in the CPAP tubings. We use Fisher and Paykel Bubble CPAP and are fortunate that they are very responsive to any concerns we have with the system. They are currently trialling a new configuration of tubing and heating wires that will be able to be used with both high flow and CPAP, so hopefully we will have a new improved version before too long. In the meantime, it is again for the nurses to be vigilant about removing condensation from the tubing before it gets as far as the baby - for some babies this is every half hour or so. I will keep the group informed of any new developments as I hear of them.
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Guest shesu

Thank you for the update, I'm keeping my fingers crossed they're really going to fix the condensation problem. The reality of NICU's is that it really isn't feasible to make all infants on CPAP or hi flow cannula one to one assignments which is necessary to continually monitor the rain out involved with the current set up. I'd love to be able to have hi flow cannulas re introduced to our unit but it won't happen until this issue is resolved. Please keep me up to date on any new developments as the company no longer communicates with our unit. Thank you again.

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