PDA

View Full Version : Questions about HMEs


Niff
04-19-2009, 10:08 PM
I'll probably be posting tons of questions in the next few weeks so I apologize ahead of time!

I see a lot of pictures of kids with bare trachs (without HMEs). How do you keep the moisture just right? I'd be afraid of increased risk of infection from the open trach as well as them drying out.

Also, how did you find the HME that was right for your child? Mackenzie is on CPAP but on the trach collar 2hrs BID (sometimes she tolerates it and sometimes she doesn't). Since the trach collar isn't exactly portable, we tried an HME with oxygen attached and it didn't work at all. Within seconds she was tachypneic and really struggling.

And for parents with vented children, did you have to provide extra support in the beginning to compensate for the resistance with the vent HMEs?

lynn
04-19-2009, 10:26 PM
Joseph did fine with the hme from the first try- but, we were using the humidvent mini- I dont think they provided much resistance against the vent
I have a couple if you would like me to send for you to try- we dont use them anymore, they are too small for Josephs tidal volume now.

The only time we dont have trach covered is when changing from his downstairs"outting" vent to his upstairs bedtime vent- I am so nervous about getting some foreign object sucked into it. (although we do have a lot of pics that I just popped vent off so I could move him somewhere and get a good pic without untangling and moving the vent with him)

Niff
04-19-2009, 10:48 PM
Joseph did fine with the hme from the first try- but, we were using the humidvent mini- I dont think they provided much resistance against the vent
I have a couple if you would like me to send for you to try- we dont use them anymore, they are too small for Josephs tidal volume now.

The only time we dont have trach covered is when changing from his downstairs"outting" vent to his upstairs bedtime vent- I am so nervous about getting some foreign object sucked into it. (although we do have a lot of pics that I just popped vent off so I could move him somewhere and get a good pic without untangling and moving the vent with him)


I'll ask our DME RT about it tomorrow and see if they can get one in for Tuesday. I don't think it'll be a problem, and I'd hate for you to go through the trouble of mailing it out if we can get it through Apria.

bryantem
04-19-2009, 11:43 PM
We use the humidvent mini too. With any HME, Addisyn gets a ton of secretions. She actually does better with nothing. When we go out, I put an HME on, but she knocks it off all of the time. I do not ride in the car with it where I can't get to her quickly.
________
Iphone games (http://macgame.org)

Alex's mom
04-20-2009, 06:38 AM
Alex is on the vent all the time so there isn't much time where her trach is just opened and exposed except when moving from one room to another.

We did start off with a small hme that was blue... I'd have to go find one to see what it was.

We've never had to change the vent settings to accomodate the change in pressure with an hme. I've always wondered about that but she never seemed to be in any type of distress because of it.

Mackenzie is still small - when she gets bigger and a little stronger she may start tolerating the hme in time when off the mist. Alex doesn't do well at all when she's dry, so we are never without an hme if she's not hooked up to the home vent w/the humidification.

There was a time we tried weaning off the vent and it was a real challenge for us. The hme caused her to be junky very quickly and it was really difficult for her - but without the hme she was too dry. (not a big surprise because she didn't do well managing her secretions on the mist either)

TommysMommy
04-20-2009, 07:47 AM
Tommy wore a Thermovent T for the first year. After that he was humidified O2 all the time, so no need for one. We have lots of pictures without him wearing his T because taking it off was one of the first things he learned to do. Many times I would be taking pictures when he took it off and I just kept snapping away and put it back on afterwards.

KJKK8437
04-20-2009, 09:40 AM
We use the humidvent mini too. With any HME, Addisyn gets a ton of secretions. She actually does better with nothing. When we go out, I put an HME on, but she knocks it off all of the time. I do not ride in the car with it where I can't get to her quickly.

Have you tried the Portex Ts? We found a huge improvement in secretions when we switched to that one. I know that others have not had this good luck, though, so maybe its an Alex thing. But, our RT said that an HME of the wrong tidal volume can cause excess secretions.

saywhatyouwill
04-20-2009, 10:49 AM
hi niff

emily wears her tube w/o a covering. this is what was recommended by her consultant. she hasn't worn an HME since she was small but at that time couldn't actually tolerate it.

when she came home she had an abundance of secretions. i suppose in her case it was helpful that her trach was uncovered. she has humidity overnight (but not every single night) but that's it. if she gets dried out then we use saline drops (rarely) or a nebuliser (even more rarely). she also has filter bibs that she wears in environments where we know the air is really dry (like at nursery). just that small amount of extra humidity seems to be enough for her.

it's just trial and error :-)

bryantem
04-20-2009, 12:14 PM
Have you tried the Portex Ts? We found a huge improvement in secretions when we switched to that one. I know that others have not had this good luck, though, so maybe its an Alex thing. But, our RT said that an HME of the wrong tidal volume can cause excess secretions.

We have some humidvent T's but her chin is so chubby that they fall off. Her pulm said they make a trach extender for the Shiley's so I am going to ask about that. She was occluding her trach the other day with her chin. She was doing fine breathing, so I left her alone for "practice", but we still can't have her doing that when in the car or unsupervised.
________
FORD MOTOR COMPANY LAMP FACTORY HISTORY (http://www.ford-wiki.com/wiki/Ford_Motor_Company_Lamp_Factory)

drct1245
04-20-2009, 09:10 PM
We too used the humidivent mini w/ our vent and never had to do any settings changes.. and Ayden was very sensitive at the time to settings.

Once off the vent we went to the T's. The extender I don't think is specific to the shiley (they didn't have one when I was looking.. but they always come out w/ new stuff), ours was just a flexitube that wasused as part of our vent connection originally.

delightdee
04-21-2009, 01:01 AM
Who makes the humidivent mini? We have some huge airlife HMEs and they suck! Luke hates them and they don't provide any moisture for him.

Andrew's Mommy
04-21-2009, 01:38 AM
I just put a couple of drops os saline down my sons trach. That and he has adjusted to our climate. He only really needs humidification at night when its been really hot outside all day. So i bought a cool mist humidifer and that works for him so far

KJKK8437
04-21-2009, 08:42 AM
We have some humidvent T's but her chin is so chubby that they fall off. Her pulm said they make a trach extender for the Shiley's so I am going to ask about that. She was occluding her trach the other day with her chin. She was doing fine breathing, so I left her alone for "practice", but we still can't have her doing that when in the car or unsupervised.

In our experience, Humidivent Ts came off too easily, too. The difference in using the Portex is that the Portex has a "neck" built in to the HME. For the humidivent, the trach is almost "inside" the barrel shape of the HME, but the Portex have a little pedrpendicular tunnel that the trach fits into instead.

Oh, this is confusing. I'm sure I did a lousy job explaining that. I wish I still had one to photograph for you.