Humidification ppt by Dr.gokulakrishnan janarthanan

Methods by which humidified air can be introduced into the Respiratory system
Important for mucous production, ciliary activity and healthy respiratory tract
Air become 100% saturated with water vapor

1. Humidification
GOKULAKRISHNAN.J .,MPT(Sports Medicine)
Assisstant Professor

2. Introduction
•Methods by which humidified air can be
introduced into the Respiratory system
•Important for mucous production, ciliary
activity and healthy respiratory tract
•Air become 100% saturated with water
vapor
•Upper respiratory tract function
•Humidifying the air before passing carina

3. Methods of administration
•Temperature is 32°C to 36°C.
•Mask
•Nasal cannula
•Tracheostomy tube
•Endotracheal tube

4. Types of humidifier
•Boys and Howells (1972) classified
humidifiers into suppliers and conservers
of water
•Suppliers
–Ambient temperature vapour suppliers
–Heated vapour suppliers
–Ambient aerosol suppliers
–Heated aerosol suppliers

5. Ambient temperature vapour
suppliers
•Gas is bubbled through room temperature
water
•Bubble through humidifier

6. Heated vapour suppliers
•Gas is passed across heated water
•Alternatively it may be dripped onto a very
hot plate (Kontron)
•Tube heated to avoid heat loss
•39 C
•Thermometer control
•Cut off mechanism

7. Ambient aerosol suppliers
•These produce a mist of liquid water either by
breaking up water entrained by a high
pressure gas (Bernoulli principle)
•Generating the mist with a high speed
spinning disc or an ultrasound vibrating crystal
•Very dense mist – danger of over load
•Babington principle - whereby air is forced
through a fine film of water, and this produces
a particularly dense mist

8. Heated aerosol suppliers
•The water to be nebulized is heated, and
in particular the Bernoulli-type devices are
often made to take a heating element or
‘hot rod’.
•Thermal safety again is essential
•Bernoulli's principle 
states that an
increase in the speed of a fluid occurs
simultaneously with a decrease in
pressure

9. CONSERVERS
•These heat and moisture exchangers
(HMEs), or condenser humidifiers
•Trap expired heat and water in a mesh,
and return it in fresh inspired gas
•They can be reasonably efficient but are
prone to blockage by secretions
•Disposable examples are available
•(Portex; Siemens; Engstrom)

10. Choice of humidifier
•Cost
•secretions are already thick, droplet
humidity is better at loosening them than
vapour
–Ultrasonic are the best for this purpose and
they are also irritant and promote coughing
•Cold droplets bronchoconstriction not for
asthmatics
•And produce hypo thermia

11. Hazards
•Infection – 60
0
C
•Broncho constriction – cold humidifier

12. Aerosol therapy
•Suspension of liquid or solid particle in gas
•Two forms
–Small volume nebulizer
–Metered dose inhaler
•Instruction in the correct use of an inhaler is often
necessary to ensure that the maximum amount of the
drug enters the lungs and is not lost to the atmosphere
•Approximately 10 per cent of the drug actually reaches
the bronchi, the rest being swallowed
•A good technique is essential

14. Pressurized aerosol

15. Technique
•Breathe out quietly and having placed the
aerosol to the mouth, should press the
actuator firmly while breath in deeply
•Hold for 10 sec
•If bronchodilator and steroid therapy
•First dilator – widening of bronchi 15 mins
after steroid

16. Rotahaler
•The patient must be shown how to insert the
capsule into the
•Rotahaler, that is, the colored end first
•Twist the Rotahaler to break the capsule and then
to inhale deeply to get the powder into the major
airways
•Several breaths may be needed to inhale all the
drug
•This device does not require the coordination of
the aerosol

18. Spin haler
•This device is similar to the Rotahaler,
except that the outer sleeve slides down
the inhaler to pierce the capsule
•A propeller inside to disperse the drug

20. Spacer
•This device designed for patients who could
not coordinate inspiration with the depression
of the actuator on the pressurised aerosol
•Mouthpiece (a)
•Actuator(b)
•Middle section (c)
•Allowing him a little more time to inhale
without losing the required drug

22. Nebuhaler
•The mist from a pressurised aerosol is emitted in
the shape of a pear
•The aerosol slots into one end (a)
•The mouth at the other end next to a one-way valve
(b)
•The patient seals his lips around the mouthpiece
•Depresses the actuator the required number of
times and then takes several breaths in to clear the
trapped mist
•This device overcomes the lack of co-ordination

24. NEBULISERS
•Some patients with severe reversible
airways obstruction
•Need larger doses of a bronchodilator to
achieve maximum lung function
•This can be administered in the form of a
nebuliser
•There are many forms of nebuliser
•The majority work on the venturi effect

25. Venturi Mechanism
•A stream of gas is passed through a small hole
•It creates a lower pressure as it emerges from that hole
•In the case of nebulisers, there is a small tube, with
one end immersed in the bronchodilator solution and
the other end near the area of low pressure
•Consequently, the liquid is drawn up the tube
•Then pushed on to a baffle, which splits the liquid into
tiny particles,
•The small hole can become blocked with saline and the
nebuliser should be rinsed after use

27. Piezo electric
•Liquid is set into motion by the vibrating crystal
•This nebuliser is suitable for home use and is much quieter
•The larger models are very useful for delivering high
humidity to patients with tenacious sputum to aid
expectoration
•For most patients nebulisers the driving gas can be oxygen
•However, if the patient is hypercapnoeic then compressed
air should be used
•This can be in the form of an air compressor or an air
cylinder

29. THANK YOU