First let us find out exactly what Vapotherm High Flow Oxygen Device is and how it compares to other high flow devices. An article in CHEST (https://journal.chestnet.org/issue/S0012-3692(16)X6303-9) found that Vapotherm performed as well as a Non-Rebreather system which used a face mask.  The Vapotherm system uses a high flow cannula instead of a mask.

The reason that the Vapotherm was introduced in my case was so that I could eat and to get a break from the Bi-pap. I was on what was the equivalent of 9 liters of oxygen.  The 9 liters of oxygen from the oxygen fixture on the wall was not keeping me well saturated, but the equivalent from the Vapotherm did. Someone who reads this will be able to supply the answer as to why. My feeble attempt is that the oxygen coming through the high flow cannula from the Vapotherm machine was under pressure and cleared out what is termed as the dead space in the respiratory process. Dead space is defined as the volume of air that is inhaled that does not take part in the gas exchange.

My personal feeling is that this was much better than the alternative which was being discussed in my room by the pulmonologist and his students. The alternative was the Bi-pap for 24 hours with intravenous feeding and hydration. Though not discussed, I was aware that intubation was another alternative.

The high flow cannula was making my ears sore, but that was a side effect that I was willing to live with, but luckily, I was able to go to the regular oxygen the next day.

The machine that I was on appeared to have its own concentrator, though I have not been able to locate such a device in the literature about Vapotherm. Here is the promotional from a rural hospital which is quite informative. Precision Flow | Vapotherm High Velocity Therapy