Introduction =Humidity therapy involves adding water vapor and (sometimes) heat to the inspired gas. = The primary goal of humidification is to maintain normal physiologic conditions in the lower airways. help ensure normal function of the mucociliary transport system. =A humidifier is a device that adds molecular water to gas.Indications A. PRIMARY Humidifying dry medical gases Overcoming humidity deficit created when upper airway is bypassed B. SECONDARY Treating bronchospasm caused by cold airPhysical Principles Governing Humidifier Function ‘Temperamre: The higher the temperature-of a gas-the more water vapor it can hold (increased capacity) or vice versa- Surface area: The greater the surface area of contact between waterand gas. the more oppormnity there is for evaporation:to occur. Contact time: The longer a gas remains in contact with water. the greater is the opportunity for evaporation to occur: Thermal mass: The greater the mass of water or the core element of a humidifier: the greateris its capacity to hold and transfer heat.Types of Humidifiers Humidifiers are either ‘active (actively adding heat or water or both to the device-patient interface) passive (recycling exhaled heat and humidity from the patient).Active humidifiers (1) bubble humidifiers. (2) Pass over humidifiers. (3) nebulizers of bland aerosols. (4) vaporizersActive humidifiers (1) bubble humidifiers. (2). Pass over humidifiers. (3) nebulizers of bland aerosols. (4) vaporizersBubble humidifier A bubble humidifier breaks (diffuses) an underwater gas stream into smail bubbles. Use of a foam or mesh diffuser produces smaller bubbles than an open jumen- allowing greater surface area for gas/water interaction. Unheated bubble humidifiers are commonly used with oxyzen (O2) delivery systems to raise the water vapor content of the gas to ambient levels.Passover humidifiers Passover humidifiers direct gas over a-surface containing water. There are three commomtypes of pass over humidifiers (1). simple reservoir type. (2). wick type, (3) membrane typeSimple-reservoir The simple reservoir device directs gas over the surface of a volume of water (or fluid). The surface for gas-fluid interface is limited Wick humidifier Uses an absorbent material to increase the surface area for dry air to interface with heated water. a wick is placed upright with the gravity= dependent end in a heated water reservoir. Heating elements might be below or surrounding the wick. Capillary action draws water up from the reservoir and keeps the wick sarurated. As dry gas enters the chamber. it flows around the wick. quickly picking up heat and moisture and leaving the chamber saturated with water vapor.Membrane-type humidifier A membrane-type humidifier separates the water from the gas stream by means of a hydrophobic membrane: Water vapor molecules can easily pass through this membrane, but liquid water (and pathogens) cannot.Heat Moisture Exchanger An HME is a passive humidifier also described as:an “artificial nose.” Similar to the nose. an HME captures exhaled heat and moisture and retums-up to 70% of the heat and humidify to the patient during the next inspiration. ‘In contrast to the nose. with its rich vasculature and endothelium. most HMEs do not actively add heat or water to the systemNebulizers large-volume-jet nebulizers: ultrasonic nebulizers (USNs)Large- Volume Jet Nebulizers. ‘These devices are pneumatically. powered-attaching directly to a flowmeter and compressed gas source Liquid particle aerosols are generated by passing gas-at a high velocity through a small~jet” orifice- The resulting low pressure at the jet draws fiuid from the reservoir up to the top of a siphon mbe-where itis ‘shattered into liquid particles sheared off and: The large. unstable particles fall out of suspension or impact on-the intemal surfaces of the device. incindine the fluid surface (batiling).. ‘The remaining small particles leave the nebulizer through the outlet port. carried in the gas stream.Nebuli: ultrasonic nebuliUltrasonic Nebulizers AUSN is an electrically powered device that uses a pieznelectric crystal to generate aerosol. ‘This crystal transducer converts radio-waves into high-frequency mechanical vibrations (sound). These vibrations are transmitted to a liquid surface- where the intense mechanical energy creates a cavitation. in the liquid. forming a standing wave that sheds aerosol droplets-