ON - LABEL - Vapotherm

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					                       Adult - Abstracts ON - LABEL
  Affiliation   Year                                                                                                        Author      Conclusion
                       (PDFs on website at http://www.vtherm.com/forclinicians/trials.asp)

                                                                                                                                        * None of the cartridges opened at the CDC or FDA tested
                                                                                                                                        positive. Analysis involving cultures of new, unopened
    AARC        2006 An Independent probability analysis of Vapotherm ralstonia clonization                                Granger
                                                                                                                                        Vapotherm cartridges, showed there is a high probability that
                                                                                                                                        these were contaminated with Ralstonia at the Hospital.

                                                                                                                                        * Analysis does not show a common source of colonization
                                                                                                                                        by Ralstonia mannitoliltica but only proves that these are all
    AARC        2006 An independent analysis of possible patient ralstonia colonization or infection by Vapotherm          Granger
                                                                                                                                        the same, species that migth be expected in hospitals where
                                                                                                                                        cystic fibrosis patients are treated.

                                                                                                                                        * Vapotherm can be successfully applied to scoop
    AARC        2005 Use of the Vapotherm with transtracheal scoop patient - Case Study                                     Hargett
                                                                                                                                        transtracheal oxygen catheters

                       Respiratory insufficiency following lung biopsy and wedge resection: Unique patient's perspective                * HFT with NC offers a comfortable and effective method to
    AARC        2005                                                                                                       Pinichello
                       Case Report of high flow therapy with nasal cannula                                                              support patients with respiratory insufficiency

                                                                                                                                        * Vapotherm was able to provide supplemental oxygen with a
    AARC        2005 Case Report: Alpha - 1 antitrypsin treatment with Vapotherm during exercise                             Hawk
                                                                                                                                        significant increase in comfort

                     Equipment investigation of Vapotherm 2000i to warm -26˚C heliox gas mixtures, 100% helium and
                                                                                                                                        * Caution should be exercised in administering -26˚C or 51˚C
    AARC        2005 100% oxygen to 37˚C and to cool 51˚C heliox gas mixtures, 100% helium and 100% oxygen to               Polston
                                                                                                                                        source gases using Vapotherm

                                                                                                                                        * TTAV using Vapotherm may be delivered safely and
    AARC        2005 Transtracheal augmented ventilation with Vapotherm 2000i in the home                                  Garwick
                                                                                                                                        effectively in the home

                                                                                                                                        * Higher oxygen concentration was attained breathing with
    AARC        2004 Pharyngeal oxygen concentration in normal subjects wearing high flow nasal cannula                    Wettstein
                                                                                                                                        mouth open vs. mouth closed

                                                                                                                                        * Care is warranted when discussing and using
    AARC        2004 Evaluation of RC Medical, Inc./Western medica heliox regulator #M1-280-16FM                            Polston
                                                                                                                                        helium/oxygen mixtures

                                                                                                                                        * Vapotherm may serve as a useful accessory for Heliox
    AARC        2004 Heliox (70/30 He/O2) via the Vapotherm 2000i                                                           Polston
                                                                                                                                        (He/02) delivery

                                                                                                                                        * In patients with respiratory insufficiency, HFNC may be
    AARC        2004 High flow oxygen via nasal cannula during respiratory insufficiency following Pneumonectomy           Manning
                                                                                                                                        considered over traditional mask systems

                       A Case Study: Utilizing the Vapotherm 2000i high flow nasal cannula system to rewarm a                           * Vapotherm used in rewarming of nonintubated hypothermic
    AARC        2004                                                                                                        Hewitt
                       nonintubated hypothermic trauma patient                                                                          trauma patient

                                                                                                                                        * The Vapotherm cartridge may be expected to act as an
    AARC        2004 Verification of the bacteriological filtration properties of the Vapotherm cartridge                  Bamford
                                                                                                                                        effective bacteriological filter

                       Can the Vapotherm high flow nasal cannula system substitute for non-rebreathing mask in select                   * Vapotherm can be used on select patients in lieu of a non-
    AARC        2003                                                                                                         Voss
                       patients                                                                                                         rebreathing mask

                                                                                                                                        * HFNC delivery is more efficacious than the non-rebreather
                       High flow nasal vs high-flow mask oxygen delivery: tracheal gas concentrations through a head
    AARC        2002                                                                                                         Tiep       mask at equivalent flows, due to O2 storage in the upper
                       extension airway model

Revised May 1, 2008 ON-LABEL                                                                                                                                                                        Page 1
                       Helium/Oxygen (Heox) in the emergency room: Comparison of open system via high flow cannula                  * HFNC may be the preferred route for HeOx administration
    AARC        2002                                                                                                     Meyer
                       vs. closed system                                                                                            in acute asthma

                                                                                                                                    * Higher flows of nasal oxygen provide an alternative
    AARC        2002 Oxygen concentrations via nasal cannula at high flow rates                                        Malinowski   technique to simple non-rebreathing masks for administering
                                                                                                                                    higher inspired oxygen concentrations

                                                                                                                                    * The ability to set F1O2 and lessen mucosal irritation may
     ATS        2003 Evaluation of a new high-flow gas humidification device                                            Waugh       allow more complex/invasive modalities to be avoided and
                                                                                                                                    improve patient comfort and compliance

                                                                                                                                    * Vapotherm offers additional relief in dyspnea patients with
     ATS        2003 Effect of Vapotherm on dyspnea in patients hospitalized for acute exacerbation of COPD              Patel

                                                                                                                                    * Vapotherm is an alternative O2 delivery device that may
                       Effect of Vapotherm, a high-flow humidified 02 delivery device, on breathing in COPD patterns
     ATS        2002                                                                                                    Nugent      improve exercise performance in severe O2 dependent
                       during exercise
                                                                                                                                    COPD patients

                       Administration of high-flow, vapor-phased, humidified nasal cannula air decreases work of                    * HF-HNC has the potential to decrease WOB, especially at
     ATS        2001                                                                                                   Ciccolella
                       breathing in healthy subjects during exercise                                                                higher workloads

                       Effect of high-flow, vapor-phased, humidified nasal cannula oxygen on ventilatory mechanics,                 * HF-HNC has the potential to increase arterial oxygen in
     ATS        2001                                                                                                   Ciccolella
                       blood gases and comfort in severe hypercapnic COPD patients and normal subjects at rest                      COPD patients comfortably using a nasal cannula

                                                                                                                                    * Vapotherm helps augment ventilation and oxygenation in
   CHEST        2006 Nasal Cannula O2 Delivery System Improves Oxygenation & Ventilation in Adult Burn Patients         Chung
                                                                                                                                    patients with a high oxygen requirement

                                                                                                                                    * Vapotherm is as effective as a NRB mask at delivering high-
   CHEST        2003 Vapotherm: A novel high-flow oxygen delivery system                                               Guerrero
                                                                                                                                    flow oxygen

                       Adult - Articles ON - LABEL
  Affiliation   Year                                                                                                    Author      Conclusion
                       (PDFs on website at http://www.vtherm.com/forclinicians/trials.asp)
                                                                                                                                    * Vapotherm has the most safety features of all three devices
                2006 Comparision of High Flow Nasal (HFNC) Devices                                                       Walsh      (F&P, AquinOx & Vapotherm 2000i) which could possibly
                                                                                                                                    prevent adverse events.
                                                                                                                                    * Salter Labs and Vapotherm devices exceed minimum
                2004 An evaluation of 2 new devices for nasal high-flow gas therapy                                     Waugh       humidification standards at higher-than-traditional flow and
                                                                                                                                    meet ASTM standards

                                                                                                                                    * The nasal cannula has been shown to be useful in giving
 AARC Times     2004 New treatment options with the nasal cannula                                                       B. Pruitt   safe high-flow oxygen and heliox as well as pulsed doses of
                                                                                                                                    nitric oxide

                                                                                                                                    * Patients with severe COPD felt less dyspneic and
   CHEST        2004 The effects of high-flow vs low-flow oxygen on exercise in advanced obstructive airways disease    Chatila     exercised longer while receiving humidified HFO compared
                                                                                                                                    to LFO delivery

                                                                                                                                    * Vapotherm and HFT-NC is an effective method for treating
   Advance      2002 Winning by a Nose                                                                                   Walsh
                                                                                                                                    hypoxemia in patients with CHF

Revised May 1, 2008 ON-LABEL                                                                                                                                                                    Page 2
                       PICU - Abstracts ON - LABEL
  Affiliation   Year                                                                                                       Author         Conclusion
                       (PDFs on website at http://www.vtherm.com/forclinicians/trials.asp)

                                                                                                                                          * Anticipating discharge on supplemental O2, the plan of
     AARC       2004 Nitric oxide delivery with high flow nasal cannula: A Case Study                                       Fencl         care was to gradually wean flow instead of oxygen

                       Case Study: Successful extubation of a former preme infant using Vapotherm high-flow therapy       Martinez-       * Vapotherm prevented reintubation or subsequent
     AARC       2004
                       after multiple attempts using conventional methods                                                  Gomez          tracheostomy for patient

                       Comparison of Vapotherm 2000i with a bubble humidifier for humidifying flow through an infant                      * Allows supply of breathing gas by NC in the neonatal flow
     AARC       2003                                                                                                        Walsh
                       cannula                                                                                                            range with no airway cooling or drying

                       Temperature propagation with the Vapotherm high flow nasal cannula: Use model of pediatric and                     * Different flow characteristics likely account for differencies
   Pediatrix    2005                                                                                                      Goldstein
                       infant cannula                                                                                                     in temperature propagation between catheters

                       PICU - Articles ON - LABEL
  Affiliation   Year                                                                                                       Author         Conclusion
                       (PDFs on website at http://www.vtherm.com/forclinicians/trials.asp)

     TBD        TBD TBD                                                                                                      TBD          TBD

                       NICU - Abstracts ON - LABEL
Affiliation     Year                                                                                                       Author         Conclusion
                       (PDFs on website at http://www.vtherm.com/forclinicians/trials.asp)

                                                                                                                                          * At flow rates > 5 L/min on HFNC, the WOB, ∆P, and CL
     PAS        2008 High flow nasal cannula in preterm infants: Effects of high flow rates on work of breathing        Pyon/Saslow
                                                                                                                                          were not significantly different than NCPAP6.

                       Phsiologic mechanisms of high flow nasal cannula therapy (HFT) with two degrees of leak around                     In clinical application, HFT can be used to improve
     PAS        2008                                                                                                    Frizzola/Miller
                       nasal prongs.                                                                                                      oxygenation while enhancing C)2 elimination
                                                                                                                                          * A measured increase use in both mechanical ventilation
     AARC       2006 Impact of Vapotherm recall on patient care in the NICU                                                 Ashe          and nCPAP directly related to the recall of the Vapotherm
                                                                                                                                          2000i device.
                                                                                                                                          * Retrospective study demonstrates the efficacy and safety
     AARC       2006 High Flow Nasal Cannula Use in the Neonatal and Cardiac Intensive Care Units                          Reeder
                                                                                                                                          of the Vapotherm HFNC system

                                                                                                                                          * The Vapotherm HFNC device was well tolerated, patient
     AARC       2005 Retrospective case stud of heliox delivery to an infant via Vapotherm                               Hedgeman         appeared comfortable, family was able to interact and hold
                                                                                                                                          the baby without interruption of therapy

                                                                                                                                          * Vapotherm is a safe and effective adjunct to support infants
     AARC       2004 Safety and efficacy of the Vapotherm™ 2000i in the neonatal population                                  Sun
                                                                                                                                          with respiratory compromise

                                                                                                                                          * The average measured sound levels for infants were
    PSANZ       2006 Comparison of noise levels from two respiratory delivery systems                                       Buksh
                                                                                                                                          similar for bubble CPAP vs. Vapotherm

                                                                                                                                          * HFNC should not be used as a replacement for delivering
     PAS        2006 High flow nasal cannula therapy with Vapotherm: Yet another way to deliver CPAP?                      Kubicka

                       High flow nasal cannula use in preterm and term newborns admitted to neonatal intensive care                       * HFNC can be used safely in preterm and term infants with
     PAS        2005                                                                                                    Ramanathan
                       unit: a prospective, observational study                                                                           respiratory failure

Revised May 1, 2008 ON-LABEL                                                                                                                                                                           Page 3
                                                                                                                           * It is unlikely that the Vapotherm nasal cannula delivers a
     PAS        2005 CPAP delivery using the Vapotherm 2000i                                                    Limauro
                                                                                                                           clinically relevant level of CPAP

                       NICU - Articles ON - LABEL
Affiliation     Year                                                                                            Author     Conclusion
                       (PDFs on website at http://www.vtherm.com/forclinicians/trials.asp)

  Journal of                                                                                                   Holleman-   * HFNC use appears safe and well-tolerated. Infants
                2007 Heated humidified high-flow nasal cannula: use and a neonatal early extubation protocol
 Perinatology                                                                                                   Duray      extubated to HFNC spent fewer days on the ventilator.

  Journal of                                                                                                               * Editorial comparing two small randomized trials providing
                2006 Preterm VLBW infants: post-extubation respiratory support                                  Gilmore
 Perinatology                                                                                                              objective data regarding HFNC therapy with Vapotherm

                                                                                                                           * Vapotherm performed better than a standard high-flow
  Journal of         Comparing two methods of delivering high flow gas therapy by nasal cannula following                  nasal cannula in maintaining normal appearing mucos, a
                2006                                                                                           Woodhead
 Perinatology        endotracheal extubation: a prospective, randomized, masked, crossover trial                           lower respiratory effort, and averting reintubation, with no
                                                                                                                           recognized complications

Revised May 1, 2008 ON-LABEL                                                                                                                                                              Page 4
Affiliation   Year Adult - Abstracts     OFF - LABEL (PDFs not on website)                                               Author     Description

                     Utilizing a heated high flow nasal cannula system to warm a non-intubated hypothermic patient in               * Vapotherm 2000i used in Emergency Center as a
  SCCM        2006                                                                                                       Hewitt
                     the emergency department                                                                                       rewarming option
                     ROI analysis of cost savings from reduced ventilator days using Vapotherm to deliver high flow                 * Savings associated with using Vapotherm will pay for the
  AARC        2005                                                                                                        Boyd
                     therapy                                                                                                        units in less than half a year
                                                                                                                                    * Results demonstrate an improvement in oxygenation and a
                     Prospective evaluation of the Vapotherm 2000i delivering high flow oxygen therapy via nasal
  AARC        2005                                                                                                        Taft      decrease in respiratory rate with HFT when compared to
                     cannula in adult respiratory insufficiency
                                                                                                                                    traditional O2 therapy
                                                                                                                                    * Results double that of typical resting ventilation yielded CV
  AARC        2005 Effect of spontaneous peak flow and high nasal gas flow on upper airway pressure                      Waugh
                                                                                                                                    values close to traditional 5% standard
                                                                                                                                    * The INOvent functioned according to factory specifications
  AARC        2004 Delivery of nitric oxide via Vapotherm                                                               Newhart
                                                                                                                                    when used in conjunction with Vapotherm
                                                                                                                                    * HFT per NC may be considered as an alternative to more
  AARC        2004 High flow gas therapy via nasal cannula for respiratory insufficiency                                Sarkisian   aggressive respiratory therapy such as non-invasive or
                                                                                                                                    invasive ventilation
                                                                                                                                    * Patient stated he was more comfortable with HF system
  AARC        2004 Case Report: Vapotherm use in preventing nocturnal oxygen desaturation in severe obesity             Brennan
                                                                                                                                    than with nCPAP
                                                                                                                                    * High nasal flow through a non-occluding cannula induced a
  AARC        2004 Effect of high nasal gas flow on upper airway pressure                                               Bamford     small but consistent absolute increase in or pharyngeal
                                                                                                                                    pressure all phases of the respiratory cycle
                                                                                                                                    * The Vapotherm system using a nasal cannula resulted in
   ATS        2005 Analysis of the Vapotherm high flow oxygen delivery system versus standard oxygen delivery           Bamford
                                                                                                                                    significant improvement in SpO2%
                     High flow humidified nasal rooma air improves hypercapnia during wakefulness and sleep in
   ATS        1999                                                                                                      Nammour     * COPD patients perceived benefit with HFRANC use
                     severe COPD patients

Affiliation   Year Adult - Articles    OFF - LABEL (PDFs not on website)                                                 Author     Description

Journal of                                                                                                                          * Warmed humidified O2 accelerates core rewarming rate by
              2000 Warmed humidified inspired oxygen accelerates postoperative rewarming                                 Frank
Anesthesia                                                                                                                          approximately two-fold in mildly hypothermic patients

Affiliation   Year PICU - Abstracts OFF - LABEL (PDFs not on website)                                                    Author     Description

                                                                                                                                    The Vapotherm system can be used to deliver epinephrine in
   ATS        2008 Epinephrine Can Be Delivered in the Vapour Phase To Treat Croup                                       Coates     pharmacological doses to the respiratory system as a
                                                                                                                                    * HFNC systems may deliver substantial and uncontrolled
   PAS        2008 Effects of Flow Rate and Nares-Prong Air Leak on Delivery of Continous Positive Airway Pressure       Hasan
                   Using the Fisher&Paykel® and Vapotherm 2000i® High Flow Nasal Cannula Systems                                    (even at the intra-prong level ) CPAP to infants.

                                                                                                                                    * Offers a viable alternative to nasal or full-face mask for
 CHEST        2005 Innovative treatment of obstructive sleep apnea in down sysndrome                                      Miller    application of positive pressure in infants and young children
                                                                                                                                    with OSAS

                     Simple and reliable regulation of bubble CPAP using 100% humidified gas at body temperature                    * Devised a safe method of delivering bubble CPAP that can
  AARC        2005                                                                                                      DeMichiel
                     (Vapotherm) as the gas source                                                                                  be combined with a source of 100% humidified gas

Revised May 1, 2008 OFF-LABEL                                                                                                                                                                         Page 5
                                                                                                                                            * Patient's flow requirements was easily achieved with
                       HFNC as a rescue device from endotracheal mechanical ventilation in a pediatric patient with
   AARC         2005                                                                                                            Petsinger   modest flow through the HFNC device without elaborate
                                                                                                                                            head gear needed for bi-level support

                       HFNC with heliox for post extubation respiratory failure on an Infant with unrepaired congenital                     * With interventions that promoted improving CO2 clearance
   AARC         2005                                                                                                            Petsinger
                       heart disease                                                                                                        the patient was able to relax due to ease of WOB

                                                                                                                                            * The ability to support a tenuous patient with respiratory
                       Post extubation bridge with a Vapotherm HFNC on a pediatric patient following left main-stem
   AARC         2005                                                                                                            Petsinger   failure was recognized as a valuable tool in the critical care
                       bronchial resection

                                                                                                                                            * Provided a-traumatic high-flow supplemental oxygen and
                       Successful extubation of a former preme infant using Vapotherm high-flow therapy after multiple
   AARC         2004                                                                                                             Gomez      prevented reintubation or subsequent tracheostomy for this
                       attempts using conventional methods

                                                                                                                                            * Vapotherm with its high-flow well-saturated humidity seems
   AARC         2004 Vapotherm: A simple device becomes a simple solution in the PICU                                             Frick
                                                                                                                                            to be a comfortable, well-accepted therapy

                       Use of high flow nasal cannula on a pediatric burn patient with inhalation injury who failed                         * Able to forego reintubation of this pediatric patient by
   AARC         2004                                                                                                             Cairns
                       extubation                                                                                                           employing this new mode of therapy

 Affiliation    Year PICU - Articles      OFF - LABEL (PDFs not on website)                                                      Author     Description

                                                                                                                                            * Vapotherm therapy incorporates several theoretical
                       Use of high flow nasal cannula on a pediatric burn patient with inhalation injury and post extubation
   Burns        2005                                                                                                             Byerly     principles that could contribute to the prevention of intubation
                                                                                                                                            and or reintubation
                                                                                                                                            * HFNC may be an option for children who continue to suffer
                                                                                                                                            from residual OSA after upper airway, who aren't candidates
 Advance        2005 Another Option to treat OSA in youngsters?                                                                  Rauch
                                                                                                                                            for surgery or for those who can't tolerate continuous positive
                                                                                                                                            airway pressure

 Affiliation    Year NICU - Abstracts         OFF - LABEL (PDFs not on website)                                                  Author     Description

                                                                                                                                            * High flow oxygen therapy (Vapotherm) is comparable and
    PAS         2008 High flow oxygen in neonatal respiratory failure: Is it better than NCPAP                                    Joshi
                                                                                                                                            as effective as CPAP in neonatal respiratory failure.
                                                                                                                                            * HHFNC delivered with Vapotherm is as effective as CPAP
                       Successful Extubation in Low Birth Weight Infants: A Comparison of Continuous Positive Airway Pressure
    PAS         2008                                                                                                            Beltramo    in preventing reintubation in the first four weeks after
                       (CPAP) Versus Vapotherm
                                                                                                                                            extubation in low birth weight preterm infnats.
                                                                                                                                            * Vapotherm was used successfully and safely used to wean
International   2006 Initial clinical experience with Vapotherm - A new high flow humidification device                          Buksh      infants from positive pressure respiratory support and may
                                                                                                                                            offer some advantages over intermittent NCPAP

                                                                                                                                            * Use of early nasally-administered CDP was associated with
                       Initial management of Respiratory Distress Syndrome: Clinical outcomes associated with early                         lower morbidity and mortality than was early intubation and
    PAS         2006                                                                                                            Laskowski
                       intubation versus early continuous distending pressure                                                               surfactant administration in the management of respiratory
                                                                                                                                            distress syndrome
    PAS         2006 Safety & Efficacy of Vapotherm                                                                                         *Vapotherm appeared safe and well tolerated

                                                                                                                                            * May be used in preterm infants with mild respiratory
                       Comparison of work of breathing and changes in end-distending pressure using NCPAP and
    PAS         2006                                                                                                             Saslow     disease as an alternative to NCPAP without increased WOB
                                                                                                                                            and end-distending pressures

 Revised May 1, 2008 OFF-LABEL                                                                                                                                                                                 Page 6
                                                                                                                                          * The ease of application of the HFNC system, the reduced
                       A novel approach to re-establishing normal blood flow in a patient with coronary artery fistula with               risk of skin/nasal trauma-breakdown and the ability to alter
    AARC        2005                                                                                                          Petsinger
                       PDA and PPHN with Vapotherm                                                                                        pulmonary function justifies this strategy for mild respiratory
                                                                                                                                          * HFNC via Vapotherm in conjunction with sub-ambient gas
                     Hemodynamic altercations on a pre-operative patient with hypoplastic left heart syndrome (HLHS)                      mixture provides a route to decrease excessive PBF,
    AARC        2005                                                                                                          Petsinger
                     via a Vapotherm NC with subabmbient oxygen                                                                           improve hemodynamics and decrease the associated
                                                                                                                                          sequela of instrumentation and mechanical ventilation

                                                                                                                                          * Use of Vapotherm as initial and post extubation therapy for
    AARC        2005 The use of Vapotherm in an NICU. Effects on respiratory support and cost                                  Rojas
                                                                                                                                          RDS decreases ventilator use in NICU patients

                                                                                                                                          * The introduction of Vapotherm decreased. In particular,
    AARC        2005 Pre-Vapotherm vs. Vapotherm respiratory support in the NICU                                                Tero
                                                                                                                                          NCPAP as well as all other methods of respiratory support

                                                                                                                                          *HFNC is as effective for oxygenation purposes as NCPAP.
    AARC        2005 High flow nasal cannula vs. NCPAP in premature infants                                                    O'Day      Moreover patients seem more comfortable and there are
                                                                                                                                          fewer traumas than NCPAP

                                                                                                                                          * The Vapotherm device consistently scored higher in
    AARC        2005 Nursing satisfaction of nasal positive distening pressure devices in the newborn ICU                     Theorell
                                                                                                                                          nursing satisfaction compared to all other devices

                       The use of Vapotherm for preventing reintubation in neonates with ventricle congenital heart                       * The application of Vapotherm to neonates with SV following
    AARC        2005                                                                                                           Baxter
                       disease following cardiac surgery                                                                                  cardiac surgery did not decrease the rate of reintubation

                       Work of breathing during Vapotherm versus (NCPAP) for the treatment of respiratory distress                        * WOB is similar when comparing NCPAP of 4 cm H2O to
     PAS        2005                                                                                                           Saslow
                       syndrome                                                                                                           different flow rates of Vapotherm

                                                                                                                                          * Vapotherm provides as effective respiratory support as
     PAS        2005 Comparison of the effects of Vapotherm and NCPAP in respiratory distress in preterm infants                Nair
                                                                                                                                          CPAP in the initial treatment of respiratory distress

                                                                                                                                          * The Neopuff output can be heated and humidified
    AARC        2004 Evaluation of Vapotherm 2000i for humidification of the neopuff infant resuscitator                       Walsh      effectively using the Vapotherm, with a high RH attainable at
                                                                                                                                          a delivered gas temperature of 36˚C

                                                                                                                                          * Use of the Calibration tee is a safe and effective way to
    AARC        2004 Inovent® sample line modification for use with the Vapotherm® humidification system                       Sautel     prevent "monitoring failure" alarms with the INOVent and the

                                                                                                                                          * Very HFNC, using heated and humidified gas, may offer
    AARC        2004 Very high flow nasal cannula: Alternative to NCPAP in select ICN patients                                Sanchez
                                                                                                                                          some advantages over traditional NCPAP in some patients

                       NICU - Articles   OFF - LABEL (PDFs not on website)                                                     Author     Description

                                                                                                                                          * HHFNC was well tolerated by premature infants. Compared
  Journal of                                                                                                                              to infants managed with NCPAP, there were no apparent
                2007 High flow nasal cannula versus nasal CPAP for neonatal respiratory disease: a retrospective study Shoemaker
 Perinatology                                                                                                                             differences in adverse outcomes following the introduction of

  Journal of
                2007 High flow nasal cannula as a device to provide continuous positive airway pressure in infants            Spence      * HFNC can dleiver significant IPPs at flows >3 lpm -1

  Journal of                                                                                                                              * HFNC using Vapotherm is providing supportcomparable to
                2006 Work of Breathing using high-flow nasal cannula in preterm infants                                        Saslow
 Perinatology                                                                                                                             NCPAP6 for these infants with mild respiratory requirements

Nashville News 2005 Breathing easier. Vapotherm decreases ventilator use for preemies                                          Rojas      * Vapotherm used as a first-line option in many cases

  Revised May 1, 2008 OFF-LABEL                                                                                                                                                                             Page 7
                                                                                    * Vapotherm is clinically safe and efficient to support
NIC Journal   2004 High flow nasal cannula in the neonatal population   Jurtschke   breathing in neonates having respiratory compromise or

Revised May 1, 2008 OFF-LABEL                                                                                                                 Page 8

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