Term
| HUMIDITY AND CLINICAL USES |
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Definition
-WATER IN A GASEOUS STATE
USED FOR
HUMIDIFY DRY MEDICAL GASES
PRIVIDE 100% BODY HUMIDITY FOR PATIENTS UNDER ARTIFICIAL AIRWAYS |
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Term
| PRIMARY INDICATIONS FOR HUMIDIFICATION THERAPY |
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Definition
HUMIDIFY DRY MEDICAL GASES
OVERCOME HUMIDITY DEFICIT CREATED WHEN UPPER AIRWAY IS BYPASSED |
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Term
| SECONDARY INDICATIONS FOR HT |
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Definition
managing hypothermia
treating bronchiospasms caused by cold air. |
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Term
| effects of dry gas inhalation |
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Definition
ciliary movement impaired
airways are more irritable
increased mucus production
thick and sticky secretions |
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Term
| normal airway humidification |
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Definition
nose, pharynx, trachea and bronchial tree filter, warm and humidify inspired gas
By the time air reaches the carina, it has been wamred to body temperature (37) and it is 100% saturated
a fully saturated gas holds 44 mg of water per liter of gas with a vapor pressure of 47 mmHg |
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Term
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Definition
amount of water in a give volume of gas
actual water vapor (content)
can be measured with a drying agent
measured in mg/L |
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Term
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Definition
ratio of amount water in a given volume of gas to the amount of water the sample can hold at a specific temperature
measure by hygrometer and expressed in % |
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Term
| formula for relative humidity |
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Definition
| content or absolute humidity over capacity all times 100 |
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Term
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Definition
relative humidity at body temperature
44 mg/L is the capacity of water vapor at body temperature |
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Term
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Definition
| body humidity- absolute humidity over 44 mg/L |
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Term
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Definition
| inspired air that is not fully saturated |
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Term
| equations for himidity deficit |
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Definition
44mg/L minus absolute humidity
or
humidity deficit over 44 mg/L times 100 |
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Term
| sings and symptoms of inadequeate airway humidification |
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Definition
atelectasis
increased airway resistance
increased work of breathing
dry, nonproductive cough
increased risk of infection
thick, dehydrated secretion
substernal pain |
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Term
| factors that affect humidity |
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Definition
increased temperature
increased surface area
increase contact time |
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Term
| kinds of low flow humidifiers |
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Definition
simple difusser humidifier
bubble humidifier |
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Term
| kinds of high flow humidifiers |
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Definition
wick type humidifers
heat and moisture exchangers
vapor phase humidifiers |
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Term
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Definition
humidify dry gas
for patients on low flows of gas
below inspiratory needs of the patient < 25 30 L/ min |
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Term
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Definition
open lumen
diffuser (more efficient) creates more bubble creating greater surface area |
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Term
| important points about the bubble humidifiers |
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Definition
provides absolute humidity between 15 to 20 mg/L
less effective for flows >10 L/ min
less contact time less humidity
at high flows, it produces aerosols
increases risk of infection
heating reservoir is not recommended
condensate form in small bore tubing
use pressure relief valves
prevents reservoir from exploding
releases pressure above 2 psi. |
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Term
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Definition
two types:
passover humidifers
heat and moisture exchangers
for patients in ventilators who must receive heated humidity to prevent
dehydration of secretions
atelectasis
hypothermia
destruction of airway epithelium
provides 30 mg/L of water at 31 to 35 |
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Term
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Definition
directs gas over water surface
produce high levels of humidity
used for high flow situations
two types- wick and membrane |
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Term
| passover humidifier- Wick |
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Definition
cylinder shaped absorbent paper placed upright in water reservoir
absorb water through capillary action
evaporation of water from wick
no bubble produced
device is heated
produces up to 100% relative humidity at 37
efficiency of humidifier can be increased by increasing surface area and heat |
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Term
| passover humidifier- membrane |
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Definition
water and gas are separatedby hydrophobic membrane
water vapor passes through it.
able to maintain high sustained humidity (100% RH at 37 degrees celsius)high flows |
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Term
| heat and moisture exchangers |
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Definition
also known as passive humidifiers or artificial nose
captures exhaled moisture and heat
heats snd humidifies next inspiration
high flows
provides humidity between 10 and 31 mg/ L at 30 degrees celsius |
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Term
| HME AND DIFFERENT TYPES OF MATERIAL |
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Definition
CAN BE MADE OF ALUMINUM
NO VERY EFFECTIVE
HYGROSCOPIC CONDENSER HUMIDIFIER (HCH)
uses low thermal conductive materials
coated with wate absorbing or hygroscopic material
calcium chloride or lithium chloride
increases retention of exhaled moisture
humidies next inspiration
HYGROSCOPIC CONDENSER HUMIDIFER WITH FILTER (HCHF)
contains a thin bacterial filter
placed between condensing material and incoming gas. |
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Term
| ideal HME as recommended by ISO |
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Definition
LOW COMPLIANCE
PROVIDES 30 MG/ l OF WATER VAPOR
USE STANDAR CONNECTIONS
ADD MINIMAL WEIGHT, DEAD SPACE AND FLOW RESISTANCE TO BREATHING CIRCUIT. |
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Term
| IMPORTANT POINTS ABOUT HMR |
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Definition
USE FOR SHORT PERIOD OF TIME (UP TO THREE DAYS)
MAY CAUSE AN INCREASE IN THICK RETAINED SECRETIONS
USE CONVETIONAL HEATED HUMIDIFIER IF SO
FLOW RESISTANCE INCREASES
due to water absorption
can happen after several hours. |
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Term
| contraindications for using HME |
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Definition
INCREASED VOLUME OF SECRETIONS
THICK DEHYDRATED SECRETIONS
HYPOTHERMIA
LARGE TIDAL VOLUMES> 1000 ML
WITH AEROSOL THERAPY
SMALL TIDAL VOLUMES WITH LARGE VOLUME HME DEVICES
WITH HEATED HUMIDIFICATIONS
AIRWAY LEAKS AROUND ARTIFICIAL AIRWAY
MINUTE VOLUME GREATER THAN 10 L/MIN |
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Term
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Definition
SOLID OR LIQUID PARTICLES SUSPENDED IN GAS
PARTICLES CAN BE SUBMICROSCOPIS AND INVISIBLE OR MACROSCOPIC AND VISIBLE. |
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Term
| THREE CATEGORIES FOR AEROSOLS |
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Definition
BLAND AEROSOLS
DELIVERY OF AEROSOLS FOR UPPER AIRWAYS
DELIVERY OF MEDICATED AEROSOLS |
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Term
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Definition
SPUTUM INDUCTION
REPLENISH WATER IN AIRWAYS
REDUCE UPPER AIRWAY EDEMA |
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Term
| BLAND AEROSOLS LIMITATIONS |
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Definition
NOT AS EFFECTIVE AS HEATED HUMIDITY
MINIMALLY EFFECTIVE IN LOOSENING SPUTUM |
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Term
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Definition
CROSS CONTAMINATION
NOSOCOMIAL INFECTIONS
BRONCHOSPAMS
AIRWAY IRRITATION |
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Term
| DELIVERY OF AEROSOLS OR UPPER AIRWAYS |
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Definition
TREAT UPPER AIRWAY EDEMA
TOPICAL ANESTHESIA
TREAT RHINITIS |
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Term
| LARGE VOLUME JET NEBULIZER |
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Definition
GAS PASSES THROUGH A SMALL JET ORIFICE
LOW PRESSURE CREATED AFTER JET DRAWS UP WATER UP SIPHON TUBE.
WATER IS SHEARED OFF AND SHATTERED INTO AERSOL PARTICLES |
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Term
| IMPORTANT POINT OF LARGE VOLUME JET NEBULIZER |
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Definition
large particles fall back into reservoir
some nebulizers have baffles that break large particles into small particles
small particles exit the outlet port |
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Term
| important points for large volume jet nebulizer |
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Definition
output is 26 to 35 mg of H2O/l in nonheated units
water output for heated units is 33 to 55
heated nebulizers: greatest source of delivery of contaiminated moisture to patients
pseudomonas - most common organism of contamination |
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Term
| large volme jet nebulizers- important points part 2 |
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Definition
uses air entrainment- adjustable and determines O2 delivered
drain water out of the lazy loop.
backpressure causes fio2 to increase, less aerosol, less air entrained, less total flow. |
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Term
| aerosol therapy appliances |
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Definition
aerosol mask
face tent
tracheostomy mask
t tube |
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Term
| for aerosol therapy- nebulizer used |
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Definition
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Term
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Definition
uses piezoelectric crystal to generate aerosol
converts radio waves into mechanical waves
frequency is set by the manufacturer
frequency determines the size of the particle
signal amplitude unlike frequency determines aerosol output |
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Term
| ultrasonic nebulizers- important points |
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Definition
large volume units have built in fan
fan moves aerosol to the patient
gas source flow rate affects aerosol output
used for
sputum inductions and room humidifiers |
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Term
| hazards for ultrasonic nebulizer |
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Definition
overhydration
sudden mobilization of secretions
bronchospams
electrical hazards
water in tubing |
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