From the Guidelines
For neonates, the maximum vapotherm flow rate is ≥ 1 L/kg/min for patients up to 10 kg, and ≥ 10 L/min for patients above 10 kg, as defined by the operational definitions related to pediatric ventilator liberation 1.
Key Considerations
- The maximum flow rate for vapotherm therapy in neonates is based on weight, with a minimum of 1 L/kg/min for patients up to 10 kg 1.
- For premature infants, the maximum recommended flow rate is typically lower, ranging from 2-4 L/min, due to their delicate respiratory systems and smaller nasal passages.
- Term neonates and larger infants can tolerate higher flow rates, ranging from 4-8 L/min.
- It is essential to start at lower flows and titrate up as needed based on work of breathing and oxygen requirements to avoid complications such as barotrauma, gastric distension, and pneumothorax.
Important Factors
- The gas should always be warmed and humidified to prevent mucosal damage and ensure proper FiO2 delivery.
- Close monitoring of the infant is crucial for signs of respiratory distress, nasal trauma, or air leak syndromes when using vapotherm therapy.
- The definition of high-flow nasal cannula (HFNC) flow rates, as stated in the operational definitions related to pediatric ventilator liberation, should be followed to ensure safe and effective use of vapotherm therapy in neonates 1.
From the Research
Maximum Vapotherm Flow in Neonates and Prematures
- The maximum vapotherm flow in neonates and prematures is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, the studies discuss the use of Vapotherm and other high-flow devices in neonatal care, including their effectiveness and safety in providing respiratory support 2, 3, 4, 5.
- One study compared the effectiveness of different high-flow devices, including Vapotherm, in neonatal care, but did not specify the maximum flow rates used 5.
- Another study discussed the use of Vapotherm as a means of providing respiratory support in neonates, but did not provide information on maximum flow rates 2.
- A study comparing Optiflow and Vapotherm as extended weaning modes from nasal continuous positive airway pressure in preterm infants ≤ 28 weeks gestational age found that both devices were equally effective and safe, but did not specify the maximum flow rates used 4.
Key Findings
- Vapotherm is a device used to provide respiratory support in neonates, delivering high flows of gas at body temperature with close to 100 per cent relative humidity 2.
- High-flow nasal cannula oxygen therapy (HFNC) and continuous positive airway pressure (CPAP) are commonly used for neonatal respiratory support, with HFNC resulting in lower rates of air leaks, nasal trauma, and abdominal distension 3.
- The choice of high-flow device, including Vapotherm, may depend on individual patient needs and institutional preferences, with no significant difference in outcomes between devices 4, 5.