What Are Bubblers?
Last updated: January 2021
Some people with COPD require home oxygen. The most common delivery device for this is a nasal cannula. Cannulas have prongs that enter your nostrils allowing you to inhale a low flow of oxygen. Usually, this low flow does not cause any problems although sometimes it may discomfort.
The treatment here is to add humidity to the inhaled oxygen. This can easily be accomplished by using bubbler humidifiers. So, what are bubbler humidifiers? How do they work? Would you benefit from one? Here’s all you need to know.
What are bubblers?
As noted above, bubblers are a type of humidification device. In the 1960s, they were glass bottles that were breakable and needed to be washed. Today, bubblers are made of plastic. When the water runs out they can be thrown in the trash and a new one can then be added to the system. They are generally considered an inexpensive way of humidifying inhaled oxygen.
The appearance of bubblers may vary depending on the company that makes them but the general design is similar regardless of brand. They are small, plastic containers. They are about the size of a small tissue box that you can hold in one hand. On top of them is an adaptor so they can be attached to an oxygen flowmeter.
In the hospital, the oxygen flowmeter will be attached to the wall. In your home, the flowmeter will be attached to tanks or your oxygen concentrator. The bubbler is attached to the flowmeter. On the side of the bubbler is an attachment for your nasal cannula tubing.
The concept is rather simple. The flow of oxygen travels into the bubbler through a small tube that guides the oxygen to the bottom of the bubbler. Here, oxygen enters the water to cause gas bubbles to rise to the surface of the water. While the gas is traveling, it picks up the water, thereby increasing the humidity of the molecule. Humidified oxygen molecules then travel through the oxygen tubing and into your nose for you to inhale.1
So, in this way, bubblers humidify inhaled oxygen. The goal here is to prevent your nose from drying out. This can prevent nasal irritation caused by inhaling oxygen.
A brief bubbler history
Many people with home oxygen complain of a dry nose. Some will complain of nose bleeds or other complications from inhaling oxygen. It was assumed for many years that humidifying inhaled oxygen would prevent the nose from drying out and that this would help prevent nasal irritation due to inhaled oxygen.2
Back in the 1980s, bubblers were automatically used anytime a nasal cannula was in use. However, this was done despite the lack of evidence supporting the claim.2
A 1988 study had 99 patients inhale oxygen with bubblers and 86 without bubblers. They concluded that the bubbler was generally insignificant in reducing nasal irritation. A 1997 study confirmed these findings.2
When are bubblers indicated?
Nasal cannulas allow you to inhale a low flow of oxygen. They can deliver anywhere from 1-6 LPM. and are generally comfortable and well-tolerated by patients.3
The American Association for Respiratory Care has created guidelines on the use of nasal cannulas and bubbler humidifiers. These guidelines recommend that bubblers are not needed for flows equal to or less than 4 LPM but may prove beneficial when the required flow is 5 LPM or higher.3
Our hospital policy is in part based on these and other guidelines. We are to use bubblers only when the flow is 5 LPM or higher, however, any patient who asks for one can get one.
Each hospital has its own policy regarding bubblers. The same is true for home oxygen equipment suppliers. Some will automatically supply you with a bubbler while others will only supply you with one if you ask.
A controversial topic
The use of bubblers remains controversial. That said, they are generally considered inexpensive and may prove beneficial in some cases. Most patients who want a bubbler can usually get one.
What about you? If you use oxygen at home, do you also use a bubbler? Do you think they are helpful? Please let us know in the comments below.
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