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Temperature and Humidity Associated With Artificial Ventilation in the Premature Infant

An Integrative Review of the Literature

Ralphe, Jane L., MSN, NNP-BC, PNP; Dail, Robin B., PhD, RN, FAAN

Section Editor(s): Harris-Haman, Pamela A. DNP, CRNP, NNP-BC; ; Zukowsky, Ksenia PhD, APRN, NNP-BC;

doi: 10.1097/ANC.0000000000000519
Clinical Issues in Neonatal Care

Background: Approximately half of the 55,000 very low birth-weight infants (<1500 g) born in the United States each year develop bronchopulmonary dysplasia (BPD). Many etiologies have been associated with the development of BPD, including aberrant temperature/humidity levels of artificial ventilation.

Purpose: The purpose of this literature review is to explore what is known regarding inspired air temperature/humidity levels from artificial ventilation in very premature infants, focusing on what levels these infants actually receive, and what factors impact these levels.

Methods/Search Strategy: PubMed, CINAHL, Scopus, and Web of Science were searched. Of the 830 articles retrieved, 23 were synthesized for study purpose, sample/study design, and temperature/humidity findings.

Findings/Results: Heating and humidification practices studied in neonatal ventilation did not maintain recommended levels. In addition, human neonatal studies and noninvasive neonatal ventilation research were limited. Furthermore, ventilation settings, environmental temperatures, and mouth position (in noninvasive ventilation) were found to impact temperature/humidity levels.

Implications for Practice: Environmental temperatures and ventilatory settings merit consideration during artificial ventilation. In addition, aberrant temperature/humidity levels may impact infant body temperature stability; thus, employing measures to ensure adequate thermoregulation while receiving artificial ventilation must be a priority.

Implications for Research: This review underscores the need for further research into current warming and humidification techniques for invasive and noninvasive neonatal ventilation. A focus on human studies and the impact of aberrant levels on infant body temperature are needed. Future research may provide management options for achieving and maintaining target temperature/humidity parameters, thus preventing the aberrant levels associated with BPD.

Duke University School of Nursing, Durham, North Carolina (Ms Ralphe); and College of Nursing, University of South Carolina, Columbia (Dr Dail).

Correspondence: Jane L. Ralphe, MSN, NNP-BC, PNP, Duke University School of Nursing, 307 Trent Dr, Durham, NC 27710 (

The authors declare no conflicts of interest.

© 2018 by The National Association of Neonatal Nurses