Abstract：
Elevated peak inspiratory pressures (PIPs) cause harm via hypoventilation, barotrauma, and hemodynamic instability. Heat and moisture exchangers (HMEs) are used during mechanical ventilation to prevent heat loss, dehydration of airway mucosa, and accumulation of dried secretions. Multiple reports detail sudden HME occlusions causing increased PIPs. We describe 4 cases of gradually increasing PIPs from progressive HME obstruction that occurred within 6 months of an institutional change to a newer model. HME obstruction should be considered when PIPs are elevated. Alternative heat and moisture preservation strategies should be contemplated, as HMEs increase airflow resistance and add another point of possible malfunction.
摘要：
吸气峰值压力(PIP)升高通过通气不足造成伤害,气压伤,和血流动力学不稳定。在机械通风过程中使用热湿交换器（HME）以防止热量损失，气道粘膜脱水，和干分泌物的积累。多份报告详述了导致PIP增加的突然HME阻塞。我们描述了4例PIP从渐进性HME阻塞逐渐增加的病例，这些病例发生在机构变更到较新模型的6个月内。当PIP升高时，应考虑HME阻塞。应考虑替代的热量和水分保存策略，随着HME增加气流阻力并增加另一个可能的故障点。
