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Differential impact of flow and mouth leak on oropharyngeal humidification during high-flow nasal cannula: a neonatal bench study

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Abstract

Background

Heated humidification is paramount during neonatal high-flow nasal cannula (HFNC) therapy. However, there is little knowledge about the influence of flow rate and mouth leak on oropharyngeal humidification and temperature.

Methods

The effect of the Optiflow HFNC on oropharyngeal gas conditioning was investigated at flow rates of 4, 6 and 8 L min−1 with and without mouth leak in a bench model simulating physiological oropharyngeal air conditions during spontaneous breathing. Temperature and absolute humidity (AH) were measured using a digital thermo-hygrosensor.

Results

Without mouth leak, oropharyngeal temperature and AH increased significantly with increasing flow (P < 0.001). Mouth leak did not affect this increase up to 6 L min−1, but at 8 L min−1, temperature and AH plateaued, and the effect of mouth leak became statistically significant (P < 0.001).

Conclusions

Mouth leak during HFNC had a negative impact on oropharyngeal gas conditioning when high flows were applied. However, temperature and AH always remained clinically acceptable.

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Acknowledgements

The authors thank Dr. Scott Butler of English Manager Science Editing, Sydney, Australia, for linguistic revision.

Funding

No external funding.

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Authors and Affiliations

  1. Department of Neonatology, Charité University Medical Center, Charitéplatz 1, 10117, Berlin, Germany

    Tim Leon Ullrich, Christoph Czernik, Christoph Bührer, Gerd Schmalisch & Hendrik Stefan Fischer

Authors
  1. Tim Leon Ullrich
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  2. Christoph Czernik
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  3. Christoph Bührer
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  4. Gerd Schmalisch
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  5. Hendrik Stefan Fischer
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Contributions

UTL collected the data and wrote the manuscript. SG and FHS designed the study, performed statistical analyses and contributed to manuscript writing. All authors participated in data interpretation, critically revised the manuscript for important intellectual content, approved the final version, and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Hendrik Stefan Fischer.

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This manuscript does not contain clinical studies or patient data. The ethical approval is not needed.

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The authors declare no conflict of interest.

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Ullrich, T.L., Czernik, C., Bührer, C. et al. Differential impact of flow and mouth leak on oropharyngeal humidification during high-flow nasal cannula: a neonatal bench study. World J Pediatr 14, 305–309 (2018). https://doi.org/10.1007/s12519-018-0138-6

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  • DOI: https://doi.org/10.1007/s12519-018-0138-6

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