Original Title: Evaluación del sistema de humidificación de burbuja en la terapia de oxigeno de bajo flujo. Revisión sistemática y analisis de costes

Authors' objectives: Determine the effectiveness of bubble humidification systems in low flow oxygen therapy in non intubated adult patients admitted to hospital and to carry out an economic analysis in order to determine the cost of the procedure.

Authors' results and conclusions: For the systematic review, the search strategy threw up a total of 264 articles from which four essays were selected for inclusion in the review, including a total of 494 participants. With regard to nasal dryness, the data is not conclusive as two studies did find significant differences between patients administered with humidification and those who were not, while in another two studies there were no differences. No significant differences were found with regard to dryness of the throat, bleeding from the nose, headache, chest discomfort, rhinitis or changes in sputum. Moreover, one of the studies pointed out that, irrespective of whether humidification is used or not, the symptoms seem to abate after a few days. The costs analysis carried out indicated that at a flow of 5 l/min, the daily cost of the humidification system was in the case of scenario 1, 0.48 € and 0.58 € for scenario 2. The sensitivity analysis indicated that at a flow of 5 l/min, an increase or decrease in the duration of use of a humidifier of 15% for scenario 1 and of 18% for scenario 2, caused a decrease or increase in the daily cost of the humidification system of 15% and 12% for the former and of 15% and 22% for the latter. Conclusions There are few benefits that support the use of humidification in low flow oxygen therapy. However, the quality of the studies included in the review point to the need to carry out high quality studies performed in accordance with the real clinical conditions under which the patient is treated. The daily cost of the humidification system depends on the amount of time during which the humidifier is used, the flow per minute at which the oxygen therapy is administered and the scenario in question. In this way, the cost may range from €0.48 to €0.58.

Authors' methods: For the systematic review of the literature, a systematic search was made of the MEDLINE, EMBASE, EBM Reviews and CINAHL databases up to January 2013. Moreover, a manual search was made in order to locate additional articles in specialist magazines and a review was made of bibliographical citations of the selected studies in order to find other relevant studies. Original experimental or observational articles that assessed the effectiveness of the use of bubble humidification systems in adult patients with oxygen therapy prescription were included. Information on each one of the studies was extracted by means of critical reading templates and these were also used to assess the quality of the studies. From the viewpoint of the financier of the health system and for two economic scenarios (1. the humidifier is not changed each time it is used and 2. the humidifier is changed) the direct daily costs of the bubble humidification system in low flow oxygen therapy was calculated. In order to assess the impact that variables calculated with uncertainty might have on the costs calculation, a univariate sensitivity analysis was carried out.

Project Status: Completed

Year Published: 2013

URL for published report: https://www.euskadi.eus/contenidos/informacion/2014_osteba_publicacion/es_def/adjuntos/humidificacion_burbuja.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government