Hand to Hold's Official Blog: Written by Parents for Parents

Vapotherm Therapy

Recently, one of our readers introduced me to something called Vapotherm Therapy.  I am so excited about this new technology and wish it had been around when my preemie was in the NICU.  The following is information I found at www.chw.org (Children’s Hospital of Wisconsin website):

Vapotherm, quite simply, is a heated and humidified nasal cannula. Since it provides near 100 percent relative humidity at body temperature, the patient can tolerate much higher flows than a traditional nasal cannula. For comparison, the unit can be used up to 40 LPM on an adult. With the infant cartridge, the unit can deliver flows up to 8 LPM. The cannula looks exactly like a regular nasal cannula, but just below the chin, it is connected to a heated water tubing that surrounds the heated and humidified gas. The water tubing cocoon keeps the humidity in suspension and decreases rainout. Because the patient can tolerate much higher flows without the complications associated with a traditional nasal cannula, we are able to deliver FiO2s very close to 100 percent. Since the generation of flow through a regular nasal cannula can result in inadvertent continuous positive airway pressure (CPAP), we believe that inadvertent CPAP may be delivered with the Vapotherm cannula as well. Currently we are unable to measure the amount of CPAP generated at various flows, and research is underway across the country to explore this more thoroughly.

Vapotherm has been used to treat:

  • Hypoxemia (not responding to low flow oxygen therapy).
  • Apnea of prematurity.
  • Persistent respiratory insufficiency.
  • Upper airway obstructions and or anomalies.
  • Airway inflammation.
  • Hypothermia.
  • Nasal CPAP patients experiencing excessive mucus plugging.
  • Patients who have difficulty or the inability to consistently wear nasal CPAP; intolerance of the nasal interface (masks, prongs, pillows) or excessive breakdown of nasal area due to use of nasal CPAP and or bi-level positive airway pressure (BiPAP) therapy.

This is brilliant.  One of my preemie’s biggest struggles was congestion.  For some reason, and I’m now guessing it was when she was put on nasal cannula, my preemie suffered from constant mucus plugging, her breathing was labored and exhausting, and because of it she had a hard time with oral feedings.  The nurses had to suction her nasal passages frequently, and they even cut her nasal prongs to decrease the irritation on her nose.  Even after we brought her home on oxygen her breathing was still loud and congested.  We hardly noticed it anymore because we got used to it.  However, after learning about vapotherm therapy, I’m positive that it was after she was no longer on nasal cannula oxygen that her breathing finally got smoother and her constant congestion went away.  What a revelation!

I would love to hear more about Vapotherm Therapy and if any of your preemies got to use it.  Has it been used in place of CPAP?  How wonderful was it?  Thanks for your input.

Afton Mower About Afton Mower

After Mower (UT) lost her firstborn son at 21 weeks.  Her daughter was born a year and a half later at 27 weeks.  The NICU was overwhelming and isolating and it was through those two experiences she was led to found this social hub for parents to find the support they needed. Afton also gave birth to another daughter, born two days overdue after four months of strict bedrest. She believes it is a tender experience to hold a special baby in your arms when his spirit returns to his heavenly home, a miracle to watch tiny babies survive the risks of prematurity and a blessing to hold a healthy full-term baby after months of difficulty and sacrifices.


  1. hello. Yes my little guy was on vapotherm for 1 week. He was born at 30 weeks then switched to low flow o2 for 4 weeks.

  2. My 27 weeker was on vapotherm for around 10 weeks I think. He has a lot of lung complications and was on the vent for a month at birth, then moved to c-pap for 24 hours and then to vapotherm at 8 liters and slowly weaned down over the course of the next 10 weeks or so until he was on a single liter and could move to a tank.
    I was SO greatful for the vapotherm because if it were not around, those 10 weeks he would have had to be on the c-pap. You could tell how uncomfortable that was after just a few hours so I can’t imagine what 10 weeks would have looked like.
    As far as I know, babies are not sent home with vapotherm since it is only used for oxygen amounts greater then a liter (At least at our hospital) and they won’t send a baby home on more then a liter anyway.
    It really did help my little guy SO much and the air is nice and warm so they don’t get the drying out that is common with high liter flow on a tank.

    • Thank you for your comment, Tricia. How wonderful your 27-weeker could be on vapotherm so long instead of cpap. My 27-weeker alternated between cpap and ventilator for about a month before she finally graduated to nasal cannula, but the nasal cannula dried her nose out and irritated it so much. Thanks for your information and your thoughts.

    • Lindsey Sawin says:

      Hi Tricia,

      My name is Lindsey and I work at Vapotherm. I am trying to get in contact with you to get an update on your little guy for our Patient of the Year Celebration. Please contact me at your convenience, I would love to know how you and your family are doing?


  3. my little guy has been off and on vapotherm. He does well on it when he isn’t sick. When he does get in infection he is usually switch to cpap or a ventilator.

  4. I don’t know if they used it instead of the CPAP, but I know that they try to use it before the CPAP because babies tend to do better in the long run.
    As I told you in the email. I love that Melany was able to use it and not be intubated right away as I am told is the usual with 27wkrs.

    • Thanks Stacy. So, vapotherm comes after the ventilator and before cpap? So after cpap they still have to be on a dry nasal cannula? Or can babies use vapotherm again after cpap, instead of nasal cannula? (at least until they need 1 Liter or less, right?) I think I’m getting myself confused, I suppose I should just look it up online in greater depth. 🙂

  5. vent, CPAP (vent without intubation because it can takes breaths for the baby), Vapotherm (humidity and flow and O2) then nasal cannula (only flow up to about 1L and O2.

    it doesn’t replace CPAP, like when melany was sick they tried her on higher flows (it hasn’t been indicated whether or not the Vapothers could effectively take breaths like the CPAP) and then the CPAP, but eventually the Vent because the CPAP would stay on her little face. She needed the breaths because she was too sick to take them on their own.

  6. But when she came off the vent 48hrs later she went straight to Vapotherm.

  7. Its actually not that new. As a Nicu nurse I love it!! We were using it in Chicago when I worked there in 2001. It has taken the place of cpap in the babies that tolerate it. I love it because it gives babies the freedom to move their heads more, easier for positioning and holding, and less nasal septum breakdown:) Did I mention I love it:)

  8. My 26 weeker was on it and did wonderful with it. It made a huge difference.

  9. My 24 weeker was on it. She did very well with it! She was on the oscillator, CPAP, Vapo and came home on oxygen

  10. My 27 weeker was on it majority of his time in the NICU! The high humidification that it provided really made a difference!

  11. My little guy has been off and on it and he does well. :)- less apena

  12. I LOVE IT. My 27wkr was never on a vent (except when she got septic for 48hrs) and the vapotherm really benefited her progress. I know it isn’t very new, but some hospitals still don’t use it. They are finding long tern health benefits for preemies who spent time on the Vapotherm as apposed to other forms of respiratory during their NICU stays. After my LO got down to 1L of flow or less she went to regular nasal canula O2.

  13. We may be in the minority. My preemie is still in the NICU right now. He spent a few days on Vapotherm. We hated it. It holds humidity in the tubing. This causes water drops to build up in the tubing. Whenever we would move him, those droplets shot up the tubing to his nose causing him to sputter, cough and cry. We had to keep him on his sides. So much water came out, his hair would be soaked on the side he was laying on. It would soak his nasal and NG tube tape so much, they would come off his face. It seems to be a good concept, but the water shooting up his nose was concerning and disturbed him. Once he was at 2 or 3L, he went back to the low flow blender with humidity. Now, he’s on 100% o2 from the wall with humidity.

  14. Tanyell Greene says:

    My baby was 23w1day. She went from the,oscillator to the CPAP, then to the vapotherm. She is off of the vapotherm and on a smaller oxygen!

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