C55-13 Humidification Practices During Non-Invasive Ventilation in Hospitalized Patients: An Interim Analysis of a Multinational Survey

Introduction Over recent decades, NIV use has risen significantly, reducing the need for IMV, morbidity, and mortality. However, NIV failure occurs in 20-50% of cases, often due to poor tolerance from mucosal dryness. While upper airways are not bypassed in NIV, physiological humidification may be inadequate due to circuit leaks, high respiratory drive, elevated FiO2, mask type, mouth breathing, and use of dry gas. Adequate humidification enhances patient comfort and may contribute to NIV success. The AARC guidelines recommend humidifying patients on NIV, but actual practice patterns remain unclear. Objectives The primary objective was to assess humidification utilization and device types used. Secondary objectives included reasons for use/non-use and choice of specific humidification devices. Methods A cross-sectional, web-based survey was conducted among physicians managing adult patients with acute respiratory failure on NIV. The questionnaire assessed the utilization of humidification, device types, reasons for preferences for humidification devices, and reasons for not using humidification. Participants were recruited through professional societies and personal networks. The survey link was shared with the respiratory and critical care society members. Based on an assumed 50% humidification usage, the calculated sample size was 462. Data were analysed using descriptive and inferential statistics. Results Of 421 respondents from 20 countries, 418 consented; 407 answered the humidification question—288 (71%) used humidification, 119 (29%) did not. Among users: 176 used both heated humidifiers (HH) and heat and moisture exchangers (HME), 70 used only HME, and 42 only HH. Just 98 had a written protocol. Common reasons for not using humidification included device availability (61), incompatibility with portable BiPAP (21), unfamiliarity among staff (20), cost (16), infection risk (12), unit protocols (9), personal unfamiliarity (8), equipment safety concerns (7), patient safety concerns (5), and perceived lack of evidence (5). Only 182 of 418 respondents had formal training in humidification for NIV. Conclusions This survey offers insight into humidification practices during NIV. While most respondents use humidification, a notable minority do not—mainly due to resource limitations and operational concerns. HME-based strategies are most common. These findings underline the need for standardized protocols, improved training, and strategies to overcome barriers to humidification use in NIV. This abstract is funded by: None