Noninvasive ventilation (NIV) is the delivery of respiratory pressure support via a mask and may be used to treat respiratory failure, such as chronic obstructive pulmonary disease (COPD).1 A ventilator may generate positive pressure to assist with inspiration and expiration.2 The American Association for Respiratory Care (AARC) highly suggests heated humidification for NIV to improve comfort.3
Normal adult airwayThe respiratory system is a highly balanced mechanism reliant on humidity.4 As air travels down the airway during normal inspiration, heat and moisture are drawn from the airway mucosa until the gas reaches 37 °C, 44 mg H₂O/L close to the carina.5,6The airway mucosa needs to retain a balance of heat and moisture to maintain a fully functioning mucociliary transport system and act as an efficient line of defense. This process plays an important role in efficient gas exchange by maintaining clear and open airways with effective mucus clearance.6 The benefits of heated humidification for noninvasively ventilated homecare patientsIncreased comfort and tolerance to NIVThe gas leak, high flow rate and unidirectional flow of NIV therapy can dry the oral and nasal mucosa.7,8,9 Therefore, healthcare providers should make every effort to maximize patient comfort as it is critical to the tolerance of NIV therapy. Heated humidification is highly suggested for NIV therapy to improve comfort.3Assists natural defense mechanisms in the airwayPersistent airway inflammation and mucus retention are clinical issues for patients with chronic respiratory diseases. Homecare patients commonly use home ventilators and should use humidity to improve secretion clearance.10,11Promotes efficient gas exchange and ventilationSecretion clearance is fundamental to limiting airway occlusion and promoting efficient ventilation and gas exchange.12 Humidification is integral to secretion management in mechanically ventilated patients,10 and it assists with secretion mobilization and removal.3,13Insufficient respiratory humidification can result in diminished cilia activity, decreased cilia beat frequency, ciliary destruction and cellular damage. The resulting increase in mucus viscosity and impaired mucociliary clearance may lead to secretion retention, airway occlusion and atelectasis.14 |  The respiratory system is a highly balanced  Normal vs. occluded airway |
