Variability in incubator humidity practices in the management of preterm infants

To determine current practice and opinion in relation to incubator humidity use in the management of preterm infants in neonatal intensive care units (NICU's) within the Australian and New Zealand Neonatal Network (ANZNN).

A survey was conducted in 26 NICU's in the ANZNN. A senior clinical nurse in each perinatal centre participated in a telephone survey that focused on local humidification practices and on the clinicians' views and experiences of humidity use.

All centres routinely used supplemental humidity in the management of preterm infants. The majority of centres (77%) had written protocols to guide practice. Eighty-eight per cent commenced humidity at a high level (relative humidity > or = 80%). There was wide practice variation in the gestational age parameters determining humidification use (all gestational ages up to 37 weeks), duration of use (3-77 days), timing of initiation (admission to 72 h after birth) and weaning practices. Perceived benefits of humidification included improved thermoregulation, skin integrity, and fluid and electrolyte balance and reduced transepidermal water loss. Perceived risks included sepsis and hyperthermia.

Our study confirmed that incubator humidity is used routinely in the management of preterm infants in the ANZNN. Wide variation in humidification practices across NICUs reflects the paucity of research evidence. Perceived benefits and risks of humidity use were consistent with available literature. To optimise the care environment and provide an evidence base for practice further research is warranted.