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29
Health Care
Undergraduate 1
10/04/2010

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Term
Def: Humidity Therapy
Definition
involves applying water vapor and sometimes heat to the inspired gas
Term
Def: Absolute Humidity
Definition
actual mass or content of water in a measured volume of air
Term
Def: Humidity Deficit
Definition
difference in water vapor content between saturated gas conditions present in the lungs
Term
Def: Dew Point
Definition
temperature where water vapor condenses back to its liquid form
Term
Def: humidifier
Definition
device that adds molecular water to gas
Term
decribe: Normal Physiologic Process of Airway Humidification
Definition
(1) ambient air inspired thru nose is warmed to 34
Term
Def: BTPS
Definition
Body, Temperature, Pressure, Standard
- When gas moves into the lungs, it acheives BTPS
Term
Def: ISB
Definition
Isothermic Saturation Boundary is located 5 cm below the carina.
Point where inspired gas becomes fully saturated to 100% relative humidity at body temperature and remains constant (BTPS)
Term
3 clinical situations that causes ISB distal shift
Definition
*note: a distal shift indicates humidity therapy
1. cold, dry air
2. bypassed upper airway
3. increased minute ventilation
Term
goal of Humidity Therapy
Definition
To maintain normal physiological conditions in the lower airways
Assures normal function of mucociliary transport
Term
Primary indications for humidity therapy
Definition
1. Humidifying dry medical gases
2. Overcoming the humidity deficit when the upper airways is bypassed
Term
Secondary indications for humidity therapy
Definition
1. Managing hypothermia
2. Treating bronchospasm caused by cold air
Term
7 clinical signs and symptoms of inadequate airway humidification
Definition
1 Atelectasis
2 Dry, nonproductive cough
3 Increased airway resistance
4 Increased incidence of infection
5 Increased work of breathing
6 Substernal pain
7 Thick, dehydrated secretions
Term
3 variablees that affect the efficiency of a humidifier
Definition
1. Temperature - The > the temp. of gas, the more water vapor it can hold.
2. Surface Area - The > the SA between water and gas, the more evaporation will occur. 3.Contact Time - the longer the gas remains in contact with water, the > the amount of evaporation
Term
3 methods to increase surface area
Definition
3 methods to incr. SA: a) bubble diffusion b) aerosol c) wick technologies
Term
2 types of low flow humidifiers
Definition
1. wick
2. membrane
Term
3 types of high flow humidifiers
Definition
1. bubble
2. passover
3. heat-moisture exchanger
Term
describe: function, indications, contraindications, hazards of all types of humidifiers
Definition
ref. pg. 787
Term
def: Condensation
Definition
change of state from gas to liquid, as with water vapor condensation
Term
Factors that affect condensation in respiratory therapy devices
Definition
Temperature difference across the system
Ambient temperature
Gas flow
Set airway temp
Length, diameter and mass of tubing
Term
How to assess the need for humidification
Definition
(1) gas flow, (2) presence or absence of an artificial tracheal airway, (3) character of the pulmonary secretions, (4) need for and expected duration of mechanical ventilation, and (5) contraindications to using an HME.
Term
Based on a given scenario, choose the best humidifier device for that patient
Definition
verify against flowchart 796
Term
Common problems with low-flow humidification systems
Definition
poor mist production can be caused by inadequate input flow of driving gas, siphon tube obstruction, or jet orifice misalignment.
Term
Performance criteria for heated humidifiers
Definition
They need to provide at least 30 mg/L water vapor
Use standard connects
Low compliance
Minimal weight
Low dead space
Low flow resistance
Term
State the RH provided by a bubble humidifier
Definition
At room temperature, 10 mg/L absolute humidity corresponds to approximately 80% relative humidity but only approximately 25% body humidity
Term
3 types of HMEs
Definition
(1) simple condenser humidifiers, (2) hygroscopic condenser humidifiers, and (3) hydrophobic condenser humidifiers.
Term
Primary use for an HME
Definition
The typical HME is a passive humidifier, capturing both heat and moisture from expired gas and returning up to 70% of both to the patient during the next inspiration.
*Note: aka the artificial nose
Term
9 contraindications to the use of an HME
Definition
1. Increased volume of secretions
2. Thick, dehydrated secretions
3. Hypothermia
4. Large tidal volumes (>700 ml)
5. Small tidal volume (VT) with large-rebreathed-volume heat and moisture exchanger (HME) (i.e., HME volume > 30% of VT)
6. Uncuffed endotracheal tubes
7. Large leak around an endotracheal tube, such as might occur with a large bronchopleurocutaneous fistula or leaking endotracheal tube cuff
8. Exhaled VT < 70% of inhaled VT
9. HME cannot be placed between nebulizer and airway during aerosol therapy.
10. HME cannot be used with heated humidification.
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