The guidelines recommend change each 72-96hs in the overall patient, and every 48 hours in patients with COPD, but the practice is very different between different hospitals
In our unit we don't change it on any time bound fashion and only change it as and when required basis if there s increased secretions or risk of clogging of filter thereby increasing secretions.......
We changed HME every 24 or 48 hours in known cases of lung infection. For other cases there is no time bound change.
In our unit we change them as needed (if there´s water in them, or secretions)
Every 72 hours and sometimes earlier if they get clogged with secretions etc.
Every 24 hours or earlier if clogged / waterlogged. This per national infection control guidelines that we must comply with. Having said that every 72 hours is probably OK
We change every 24 hours or earlier if they get clogged with secretions.
Hello, thanks for the answers!
Although the most significant impact of change less often the HMEs is probably related to the resistance increase (very easy to check if it occurs), it is unclear what happens to the humidification capacity of the devices over time (Is there a decrease in a absolute humidity delivered by the HMEs over time?). Maybe this is the point to check
In relation to the infections prevention, the AARC guidelines suggest that HMEs are not used in order to prevent them.
It should be changed in every new patient, no guarantee of patient respiratory system free from infections, but due to cost thing every new morning day we change it in my hospital.
We change them every 24 hours as policy but due the humidity in the SF bay area it is often every 8-12 hours when they lose the effectiveness and we change them again.
It should be noted that several of the answers focused on the use of HMEs in relation to the infections prevention. A controversy exists concerning the possible influence of these systems on the incidence of ventilator-associated pneumonia (VAP) (1,2). A significant reduction in pneumonia rate (6% versus 16%) when using HMEFs was found in a single-center study conducted with trauma patients (3). However, seven other studies found no significant difference between the two systems with regard to VAP rates, although a trend to a reduction of VAP was observed when using HMEFs (6-12). A metaanalysis on this aspect suggested that a decrease in VAP rate could exist with the use of filters (11).
You will can find the references in the attached file
We change it every 24 hours regulary, or more frequently if it's contaminated by tracheal secretions.
Attached are clinical practice guidelines promulgated by the American Association for Respiratory Care
we change them every 24 hrs, but more frequently if contaminated or gets soggy with humidity
We change them 24 hours, or more frequently if it's contaminated by tracheal secretions.
The standards of the institution, indicate use EHR over 48 hours, and also changes when is macroscopically dirty.
As an industry view it definitely depends on the material used for HME if it is polyurethane sponge due to higher moisture output it needs to be changed every 24 hours but if it is made of cellulose paper changing interval may last till 48 hours
We never change circuits or HME filters unless visibly soiled. Often HME filters need to be replaced at about 5th or 7 th day when it may get clogged with secretions or efficiency decreases
There is no peridic guidelines regarding HME replacement but yes it is soiled with secretion, HME may be discarded irrespective of time. Routinely, we changes 48-72 per hours HME in patients with obvious CAP, HAP, or VAP.