Humidification for neonates
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To manage humidity for infants born <30 weeks gestation (if an infant >30 weeks is assessed to have immature skin and thermoregulation difficulties, use of incubator humidity is not contraindicated)
- If baby is admitted on to a heat table, transfer to humidified incubator as soon as possible.
- Babies ≤28+6 weeks gestation
- Commence humidity of at least 80%
- 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).
- Babies 29-30+6 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
- Ensure hypotonic sterile water for injection is used for humidity (1000ml bag) to avoid corrosive damage in the incubator system
- Clothing should not be used in the presence of humidity.
- Check bed linen to ensure it is not damp.
To manage gas humidity for infants on respiratory support (at flows >300 ml)
- All babies requiring respiratory support at flows over 300ml (ventilated infants, those on CPAP, Humidified High-Flow or Humidified Low-flow) to receive humidified gas using the MR850 humidification system.
- Slide the warmer plate (Conventional Ventilator RT235, CPAP BC151, Humidified High-Flow/Low-flow RT329, HFOV MR290) onto the humidifier base.
- Connect 1 litre bag sterile hypotonic water to auto feed drip line.
- Push the on/off button. (The humidifier will automatically default to the intubated mode).
- Change circuits weekly.
It is suggested by Fisher and Paykel to always have the humidifier plate below the infant to allow for proper drainage of rain out - this is not always possible when the infant is out for a Kangaroo cuddle so care needs to be taken to remove condensate
- Fisher and Paykel recommendations on circuit management
- Drager / Airshields product recommendations
- 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.
- Sinclair, Crisp & Sinn (2009). Variability in incubator humidity in the management of preterm infants. Journal of Paediatrics and Child Health 2009; 45; 535-540
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- Date last published: 31 July 2010
- Document type: Clinical Guideline
- Services responsible: Neonatology
- Owner: Newborn Services Clinical Practice Committee
- Editor: Sarah Bellhouse
- Review frequency: 2 years
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