The answer is that humidified oxygen does not increase the oxygen saturation in the blood. But is that the question that we should be asking? Should we look at how many exacerbations humidified oxygen users have as compared to non-humidified oxygen users. We could look at the damage done to the nasal passages which cause bleeding especially with higher oxygen flows.
If there is no benefit to humidified oxygen, then why does the Vasotherm produce warmed oxygenated air? One of the reasons that I could not wait to get the Bi-pap machine off and the Vasotherm back on was the fact that my tongue was so dry that I could not feel it and consequently chewed on it and made it very sore.
My pulmonologist was not aware that I did not have a humidifier on my machine at home. That situation was quickly changed. Since I have used the humidifier on my home unit for about a month now, I am skeptical about the standard answer about humidified oxygen stated in the beginning of this piece. Here is a study that supports that idea
Twenty-seven randomized controlled trials with a total number of 8,876 patients were included. Non-humidified oxygen offers more benefits in reducing the bacterial contamination of humidifier bottles, as shown by the mean operating time for oxygen administration and the respiratory infections compared with humidified oxygen therapy. No significant differences were found in dry nose, dry nose and throat, nosebleed, chest discomfort, the smell of oxygen and SpO2 changes.(Wen 1917)
The routine humidification of oxygen in low-flow oxygen therapy is not justifiable and non-humidified oxygen tends to be more beneficial. However, considering that the quality of most included studies is poor, rigorously designed, large-scale randomized controlled trials are still needed to identify the role of non-humidified oxygen therapy. (Wen 2017)
When I review this, I conclude that keeping the humidifier clean is a big problem. My DME provided three bottles and instructed me to change and sterilize the bottles with vinegar once the water level got low or became milky looking. The DME emphasized that I should not fill the bottle again without cleaning it with soap and water and then rinsing with vinegar.
The second thing that I must make an observation about are the nosebleeds. I had a constant nosebleed prior to using the humidifier. Most of the time it was minimal, but occasionally it was profuse. I have not had even one spot of blood in the month that I have used the humidifier bottle.
I found several articles that proclaim the benefits of using humidification with infants. (Vives 2017)
We conclude that routine humidification of oxygen for administration by nasal cannula is not justifiable, and that cessation of this practice would result in significant reductions in both time and material costs in respiratory care. (Campbell 1998)
I did not find conflicting information on the use of humidification with high flow devices. The going conclusion was that it is necessary.
I would like to see a study where the cleanliness of the equipment was closely monitored since the introduction of bacteria seems to be the major downfall with humidification and as important to providers is the cost involved.
My personal observations do not coincide with the literature and in fact the literature seems to be sparce. I would be very anxious to participate in a controlled study concerning the benefits of adding humidity to low flow oxygen use.