What question did this study set out to answer?

The aim is to evaluate the effectiveness of the Aerogen Pro-X nebulizer versus the Hamilton H900 humidifier in providing heated and humidified oxygen during transport.

March 22, 2026Open Access

Heated and Humidified Oxygen in Critical Care Transport: Evaluating the Use of Aerogen Pro-X Nebulizer as an Alternative to Traditional High-Flow Humidifiers

Key Points

The aim is to evaluate the effectiveness of the Aerogen Pro-X nebulizer versus the Hamilton H900 humidifier in providing heated and humidified oxygen during transport.
Conducted tests using Aerogen Pro-X with Hamilton T1 ventilator.
Measured temperature and humidity at three flow rates and six FiO 2 levels.
Performed three tests for each condition: baseline, Aerogen, and H900.
H900 delivered significantly higher temperatures at 38.56°C compared to Aerogen's 19.62°C.
Aerogen showed higher relative humidity at 85.9% versus H900's 57.7%.
Neither device met guideline-compliant humidification and temperature standards across all tested conditions.

Abstract

Objective: Heated, humidified oxygen therapy is commonly used to support hypoxemic, nonintubated patients.Conventional high-flow nasal cannula (HFNC) systems are effective in hospital settings but are often large and less practical for use during critical care transport.Portable aerosol-generating devices offer a compact, transport-friendly alternative; however, a performance gap exists in their ability to maintain appropriate temperature and humidity under varying conditions compared with HFNC.We compared the effectiveness of a heated humidification device, Hamilton H900 (H900), with that of an aerosol-generating device, Aerogen Pro-X (Aerogen).Methods: The Aerogen was tested with a Hamilton T1 ventilator set to "high-flow oxygen device mode," as used in emergency responses.Using a hygrometer, we measured humidity and temperature outputs at 3 different set flow rates and 6 different set fractions of inspired oxygen (FiO 2 ) levels.Each condition was tested the following 3 times: baseline establishment, Aerogen, and H900.Results: Across all conditions, the H900 delivered significantly higher temperatures than the Aerogen, with an estimated marginal mean of 38.56C 0.34C (101.41F 2.61F) compared with 19.62C 0.34C (67.32F 2.61F) for the Aerogen (95% confidence interval CI).In contrast, the Aerogen delivered significantly higher relative humidity (RH) than the H900 at 85.9% 0.9% compared with 57.7% 0.9% for the H900 (95% CI); however, its absolute humidity was lower than that of the H900 (14.53 mg/L vs. 27.42mg/L for the H900).For both devices, RH decreased as FiO 2 and flow rate increased (P < .001).At the highest settings (FiO 2 100%, 60 liters per minute), RH declined to 71.3% 3.8% for the Aerogen and 42.3% 3.8% for the H900 (95% CI). Conclusion:The H900 maintained near-physiological temperatures, whereas the Aerogen demonstrated near-physiological RH.Although each device performed well within a specific domain, neither independently provided guideline-compliant humidification and temperature control across tested conditions.These findings support the development of a portable HFNC system that integrates efficient humidification with active temperature control for use in transport settings.

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Cite This Study

Karas et al. (Sun,) studied this question.

synapsesocial.com/papers/69bf8692f665edcd009e8f1b https://doi.org/https://doi.org/10.1016/j.amj.2026.02.009

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