Nursing Management of Humidification Levels for the Extremely Low Birth Weight Infant: A Process Improvement Protocol to Reduce Hypernatremia in the First 2 Weeks of Life.

The use of a humidified environment has long been established as a method of maintaining a thermoneutral environment and minimizing evaporative insensible water losses in the extremely low birth weight (ELBW) population. The ELBW infant is at high risk for insensible water losses leading to dehydration, excessive weight loss, temperature instability, and electrolyte abnormalities, thereby increasing the ELBW infant's risks of morbidity and mortality. Literature supports the use of a humidified environment; however, a lack of consensus has led to widespread variation in the implementation of humidity protocols. Utilizing the Iowa Model for Evidence-Based Practice, this project sought to explore whether an individualized humidification algorithm would affect the incidence of transepidermal water loss (TEWL). Results demonstrated statistical significance in sodium levels, improved median sodium levels, and improved fluid balance after implementation. Results suggested that an individualized humidity weaning algorithm may improve the incidence of hypernatremia in the ELBW infant. Further research studies are needed to describe the causal relationship between humidification and the ELBW infant's TEWL.