With Sahana, we started by taping over her HME about 50% and gradually increasing as tolerated. It was done with in consultation with her ENT and Pulm. We'd watch her extra closely, especially while sleeping.
Eventually, we got to 100% taped and switched over to a cap one morning when she woke up.
Dad of Sahana; 24-weeker born 12/2007; Acquired sub-glottic stenosis due to intubation and multiple extubations; Decanned as scheduled on April 12, 2010