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All patients that are intubated / tracheotomised must have adequate humidification of inspired gases using one of two mechanisms.
Effective first line humidifier. Conserves patient's exhaled water vapour and temperature (gas re-inspired at about 20 deg C). Still requires patient to be able to warm and humidify inspired gas to some degree.
May not be as effective at minute volume in excess of 12 1/min
HME's are changed every 24 hours.
Where any doubt exists about adequate humidification, a heated water humidifier should be the default humidifier, particularly those patients in whom there is a bronchorrhoea, sputum inspissation or haemoptysis. Generally these devices supply gas to the upper proximal airways at 29-32°C and 95-100% relative humidity.
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