Pediatric Intensive Care Unit

The Pediatric Intensive Care Unit (PICU) provides the highest level of medical care for sick children. Children whose medical needs cannot be met on the general care floor or have just come out of surgery are often transferred to the PICU. The PICU provides therapies and uses medical equipment that may not be available in other care areas, as well as intensive nursing care. The length of stay depends on the severity of a child's condition, and the medical staff will determine when a child may be discharged.

Severe breathing problems, such as those associated with bronchiolitis and asthma are common reasons for PICU admissions. Breathing support may also be necessary for post-surgery patients.


Vapotherm High Flow Therapy

High Flow Therapy (HFT) reduces the work of breathing [the effort required to breathe in and out] by washing out the CO2 from the upper airway.

Vapotherm High Flow Therapy is delivered through a small prong nasal cannula that is comfortable for the child. The breathing gas is heated and humidified to make the high flow rates easy to tolerate. The high flow rates of breathing gas flush out CO2 and fill the upper airway with fresh gas. The humidification may also be important for helping to clear mucus from the airway.

For more on the mechanisms of action click here

Preserving the temperature and humidification of the breathing gas as it travels from the Vapotherm Precision Flow to the patient is critical to providing effective therapy. If the temperature is not maintained, the humidity in the gas can condense to water in the air tube, known as “rain-out" to respiratory therapists.

Vapotherm eliminates rain-out with the warm water jacket, by using medical grade vapor for humidification, and heating the humidified gas all the way to the patient. The water jacket insulated delivery tube that transports the gas feels warm and comfortable to the touch.

For more information on Precision Flow technology click here.

Clinical Use & Flow Rate Settings

In order to maintain effective flush of CO2 it is important that the cannula not occlude more than 50% of the nares. Vapotherm offers a variety of cannula sizes, including the Solo single prong cannula that leaves one nare completely open. The Solo single prong cannula allows easier placement of a nasogastric tube, and assures an open system. Research has shown that the single prong cannula is as effective as a dual prong cannula at delivering High Flow Therapy. Read more about this.

Click here for cannula size information.

Starting flow rates depend on the age and weight of the child, and should be set so they flush the upper airway and prevent the entrainment of room air.

FiO2 should be set at a level to maintain blood oxygenation saturation as measured by patient monitors. Temperature is typically set between 36-37° C, and decreased per patient preference.

For more information on Clinical Use, including implementation and weaning, please view the Vapotherm Pediatric Pocket Guide.

For information on contraindications, please visit the Precision Flow product page.


Conditions HFT can support:

  • Acute Respiratory Distress Syndrome
  • Viral Bronchiolitis
  • Pneumonia
  • Severe Acute Asthma
  • Congenital Heart Defects
  • Separation from mechanical ventilation
  • Separation from non-invasive ventilation