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. 2018 Dec 17;8(1):126.
doi: 10.1186/s13613-018-0472-9.

Effect on comfort of administering bubble-humidified or dry oxygen: the Oxyrea non-inferiority randomized study

Laurent Poiroux  1 , Lise Piquilloud  2 , Valérie Seegers  3 , Cyril Le Roy  4 , Karine Colonval  5 , Carole Agasse  6 , Vanessa Zinzoni  7 , Vanessa Hodebert  8 , Alexandre Cambonie  9 , Josselin Saletes  10 , Irma Bourgeon  11 , François Beloncle  4 , Alain Mercat  4 ; REVA Network
Affiliations

Effect on comfort of administering bubble-humidified or dry oxygen: the Oxyrea non-inferiority randomized study

Laurent Poiroux et al. Ann Intensive Care. .

Abstract

Background: The clinical interest of using bubble humidification of oxygen remains controversial. This study was designed to further explore whether delivering dry oxygen instead of bubble-moistened oxygen had an impact on discomfort of ICU patients.

Methods: This randomized multicenter non-inferiority open trial included patients admitted in intensive care unit and receiving oxygen. Any patient receiving non-humidified oxygen (between 0 and 15 L/min) for less than 2 h could participate in the study. Randomization was stratified based on the flow rate at inclusion (less or more than 4 L/min). Discomfort was assessed 6-8 and 24 h after inclusion using a dedicated 15-item scale (quoted from 0 to 150).

Results: Three hundred and fifty-four ICU patients receiving non-humidified oxygen were randomized either in the humidified (HO) (n = 172), using bubble humidifiers, or in the non-humidified (NHO) (n = 182) arms. In modified intention-to-treat analysis at H6-H8, the 15-item score was 26.6 ± 19.4 and 29.8 ± 23.4 in the HO and NHO groups, respectively. The absolute difference between scores in both groups was 3.2 [90% CI 0.0; + 6.5] for a non-inferiority margin of 5.3, meaning that the non-inferiority analysis was not conclusive. This was also true for the subgroups of patients receiving either less or more than 4 L/min of oxygen. At H24, using NHO was not inferior compared to HO in the general population and in the subgroup of patients receiving 4 L/min or less of oxygen. However, for patients receiving more than 4 L/min, a post hoc superiority analysis suggested that patients receiving dry oxygen were less comfortable.

Conclusions: Oxygen therapy-related discomfort was low. Dry oxygen could not be demonstrated as non-inferior compared to bubble-moistened oxygen after 6-8 h of oxygen administration. At 24 h, dry oxygen was non-inferior compared to bubble-humidified oxygen for flows below 4 L/min.

Keywords: Bubble humidification; Intensive care units; Nursing assessment; Oxygen therapy; Patient comfort.

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Figures

Fig. 1
Fig. 1
Study flowchart. NIV noninvasive ventilation, HHFOT humidified high flow oxygen therapy, ICU intensive care unit
Fig. 2
Fig. 2
Absolute difference (with confidence interval) between the 15-item comfort scores at H6–H8 after randomization between humidified oxygen (HO) and non-humidified (NHO) oxygen. The non-inferiority margin was within the 90% CI of the absolute difference, meaning that the non-inferiority analysis was not conclusive
Fig. 3
Fig. 3
Absolute difference (with confidence interval) between the 15-item comfort scores at H24 after randomization between humidified oxygen (HO) and non-humidified (NHO) oxygen. NHO was non-inferior compared to HO in terms of comfort at H24
Fig. 4
Fig. 4
Relative difference (with confidence interval) between non-humidified oxygen (NHO) group mean score and humidified oxygen (HO) group mean score at H6–H8 and H24
See this image and copyright information in PMC

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