AIRVO: High-Flow Nasal Oxygen Humidification System
AIRVO is a specialized humidification system that delivers warmed and humidified high-flow nasal oxygen to spontaneously breathing patients, providing respiratory support for various conditions while improving patient comfort and secretion management.
Device Characteristics and Function
AIRVO (also known as myAIRVO2) is a humidifier with an integrated flow generator that:
- Delivers heated and humidified respiratory gases through a small, pliable nasal cannula 1
- Can provide flow rates up to 60 L/min (significantly higher than conventional oxygen therapy's 15 L/min maximum) 2
- Offers precise control of oxygen concentration (up to 100% FiO2) 2
- Maintains optimal temperature and humidity of delivered gases 1
- Generates low-level positive end-expiratory pressure (PEEP) 2
Clinical Applications
AIRVO is used in various clinical scenarios:
- Acute respiratory failure management as an alternative to conventional oxygen therapy (COT) or non-invasive ventilation (NIV) 2
- Post-extubation respiratory support to reduce reintubation rates 2
- Tracheostomy care to improve humidification and reduce excessive secretions 3
- Chronic respiratory conditions such as COPD with associated pulmonary hypertension 1
- Palliative care settings for breathlessness management 1
Physiological Benefits
The AIRVO system provides several physiological advantages:
- Improved oxygenation through higher flow rates and oxygen concentrations 2
- Enhanced ventilation through washout of anatomic dead space 2
- Reduced work of breathing compared to conventional oxygen therapy 2
- Better secretion management through optimal humidification 4, 3
- Improved mucociliary clearance by preventing ciliary dysfunction 4
Clinical Outcomes
Research suggests AIRVO may provide important clinical benefits:
Compared to NIV for initial acute respiratory failure management:
- May reduce all-cause mortality
- May reduce intubation rates
- May reduce hospital-acquired pneumonia
- May improve patient comfort 2
Compared to conventional oxygen therapy for post-extubation management:
- May reduce reintubation rates
- May improve patient comfort 2
Practical Advantages
AIRVO offers several practical benefits in clinical settings:
- Patient comfort: The small nasal cannula interface is more comfortable than NIV masks 2, 1
- Communication: Allows patients to speak, eat, and drink while receiving therapy
- Secretion clearance: Facilitates expectoration and reduces mucus viscosity 4, 3
- Portability: Efficient and portable design for various clinical environments 3
- Ease of use: Simpler to set up and operate compared to NIV 3
Clinical Considerations
When using AIRVO, clinicians should be aware of:
- The optimal temperature range for humidification is 26-29°C (80-85°F) 2
- Unlike some ventilators, AIRVO doesn't require separate humidification systems as it's integrated
- The system is designed for spontaneously breathing patients and doesn't provide the same level of ventilatory support as NIV 2
- Proper sizing of the nasal cannula is important for patient comfort and therapy effectiveness
Special Populations
AIRVO has shown particular benefits in:
- Tracheostomy patients: A study showed significant reduction in excessive tracheal secretions (40% pre-AIRVO vs 11.9% with AIRVO) and reduced need for supplemental oxygen (25% pre-AIRVO vs 7.1% with AIRVO) in head and neck free flap surgery patients 3
- Palliative care patients: Can be used at home for symptom control of breathlessness 1
AIRVO represents an important advancement in respiratory support technology, bridging the gap between conventional oxygen therapy and non-invasive ventilation while offering unique benefits in terms of patient comfort and secretion management.