For which of the following patients requiring ventilatory support would you recommend against using a heat-moisture exchanger (HME) for airway humidification?
1. Patient with an expired VT less than 70% of the delivered VT
2. Patient with a spontaneous minute ventilation of 14 L/min
3. Patient with body temperature less than 32° C
a. 1 and 2 only
b. 1 and 3 only
c. 2 and 3 only
d. 1, 2, and 3
ANS: D
Use of HMEs should be avoided in the care of patients with secretion problems and those with low body temperature (<32° C), high spontaneous minute ventilation (>10 L/min), or air leaks in which exhaled tidal volume is less than 70% of delivered tidal volume.
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