Ventilator Circuit Obstruction by a Heat and Moisture Exchange Device in a Patient Receiving Frequent Nebulizer Treatments: A Case Report and Review of the Literature

High Peak Inspiratory Pressures After a Change of Heat and Moisture Exchangers: A Case Series

“…It is believed that this obstructed the HME, resulting in the increase in PIP. 3 Despite multiple reports of abrupt occlusions of HMEs, 3,5,7 we have been unable to find examples of slowly developing occlusions in the OR setting. We report 4 cases of progressive increases in PIP due to progressive HME obstruction.…”

“…1,2 HMEs provide benefits, but they can harm in a number of ways including barotrauma, pneumothorax, and impaired ventilation due to increased resistance to expiratory airflow. [3][4][5][6] One Fico 2 report described a case of a patient who presented to the emergency department with status asthmaticus. After 24 hours of intubation with an HME inline, an abrupt increase in PIP and a decrease in tidal volume (V T ) were noted.…”