Simultaneous use of a heat and moisture exchanger and a heated humidifier causes critical airway occlusion in less than 24 hours

Abstract

We hypothesised that the simultaneous use of a heat and moisture exchanger (HME) and a heated humidifier (HH) would increase the incidence of airway occlusion over a 24-hour period in comparison with each device in isolation. This bench study compares the incidence of airway occlusion when using (group 1) no airway humidification, (group 2) a HME alone, (group 3) a HH alone and (group 4) both a HME and a HH in combination. Tracheal intubation requires the use of artificial humidification systems. HMEs are less efficient but convenient especially for a short period of intubation and HHs are commonly more expensive. Both devices are often used in close proximity on the ICU depending on the particular clinical scenario and/ or clinical practitioner. Following a critical incident of HME obstruction due to waterlogging on our ICU we realised that HH and HME may be used together inadvertently. This airway obstruction was only resolved by the removal of the HME from the patient's breathing circuit.

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