Humidification

Reviewed by Charge Nurse Newborn

November 2007


Purpose	Incubator Management	Circuit Management

Purpose	The following policy/recommended best practice outlines the use of humidification in the Newborn Service to ensure the best outcomes for babies.
Scope	Applies to all Nurses who work in Newborn Services.
Associated Documents	Company information: Fisher and Paykel recommendations on circuit management Drager / Airshields product recommendations
References	Agren (1998). Transepidermal water loss in infants born at 24 and 25 weeks gestation. Acta Paediatrica 1998;87:1185-90. Agren (2006). Ambient humidity influences the rate of skin barrier maturation in extremely preterm infants. Journal of Pediatrics 2006;148;613-17.

Humidification: Incubator Management

Follow the steps below to manage humidity for infants <30 weeks gestation

Step	Action
1	If baby is admitted on to a heat table, transfer to humidified incubator as soon as possible.
2	Babies ≤28 weeks gestation Maintain humidification at 70-80% for first 7 days If temperature stable after 7 days, wean gradually to 50% Discontinue after 21 days or 32 weeks gestation (whichever is reached first).
3	Babies 29-30 weeks gestation Commence humidification at 70-80% If temperature stable after 3 days, consider weaning humidification Discontinue when baby reaches 32 weeks gestation or when a level of 40% has been reached and has been demonstrated to be compatible with thermal stability
4	Clothing should not be used in the presence of humidity.
5	Check bed linen to ensure it is not damp.

Humidification: Circuit Management

Follow the steps below to manage gas humidity

Step	Action
1	All babies requiring ventilator support (Including Hudson CPAP) to receive humidified gas using the MR850 humidification system.
2	Connect RT235 infant ventilation circuit, and MR290 auto feed chamber to humidifier base.
3	Connect 1 litre bag water to auto feed drip line.
4	Push the on/off button. (The humidifier will automatically default to the intubated mode).
5	Change circuits weekly.

Follow the steps below to manage gas humidity for low Flow Nasal prong

Step	Action
1	Humidification must be commenced for all babies requiring ≥300ml O2 and/or compressed air via nasal prongs.
2	Choose appropriate size nasal cannula to the RT329 low flow respiratory circuit.
3	Connect to RT329 low flow respiratory circuit. (Place onto humidifier base).
4	Connect 1 litre bag water to auto feed drip line.
5	Push the on/off button. (The humidifier will automatically default to the intubated mode).
6	Change circuits weekly.