For which of the following patients requiring ventilatory support ...

[jasdeep_brar]

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

Question 2

A dehydrated, feverish patient suffering from acute bacterial pneumonia is being intubated in order to provide mechanical ventilatory support.
 
  Which of the following devices would you select to control humidification and airway tempera-ture for this patient?
  a. Unheated large-volume wick humidifier
  b. Heated wick humidifier with servo-control
  c. Large-reservoir, high-output heated jet nebulizer
  d. Heat-moisture exchanger

[juicepod]

Answer to Question 1

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.

Answer to Question 2

ANS: B
We prefer an optimal humidity approach and use of a heated humidifier to deliver gas in the range of 35 to 37 C at the airway.

[jasdeep_brar]

TY

[juicepod]

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