title: Influence of heat and moisture exchanger respiratory load on transcutaneous oxygenation in laryngectomized individuals: a randomized crossover study.
abstract: BACKGROUND
  High-resistance heat and moisture exchangers (HMEs) have been reported to increase transcutaneous oxygenation (tcpO(2)) values in laryngectomized individuals and to negatively influence patient compliance. The goal of the present study was to validate earlier published results on short-term transcutaneous oxygenation changes by high-resistance HMEs.
  
  
  METHODS
  We conducted a randomized crossover study, monitoring the influence of an HME on tcpO(2) over a 2-hour time interval in 20 subjects.
  
  
  RESULTS
  No evidence of an immediate HME effect (95% CI: -14.9-13.3 mm Hg, p = .91), or a time-dependent HME effect (95% CI: -.121 - .172 mm Hg/minute, p = .74), on tcpO(2) was found. After fitting the statistical model without time dependency, again no evidence of HME presence was seen (95% CI: -.5 mm Hg - 3.6 mm Hg, p = .15).
  
  
  CONCLUSIONS
  In contrast to earlier suggestions, there is no evidence of increased tcpO(2) levels by high-resistance HMEs in laryngectomized individuals. Thus, using such HMEs has no added clinical value in this respect.
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/ Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: J Karel
authors.initials: JK
authors.lastname: Zuur
authors.forename: Sara H
authors.initials: SH
authors.lastname: Muller
authors.forename: Michiel
authors.initials: M
authors.lastname: Sinaasappel
authors.forename: Guus A M
authors.initials: GA
authors.lastname: Hart
authors.forename: Nico
authors.initials: N
authors.lastname: van Zandwijk
authors.forename: Frans J M
authors.initials: FJ
authors.lastname: Hilgers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000403:Airway Resistance; D001785:Blood Gas Monitoring, Transcutaneous; D018592:Cross-Over Studies; D005260:Female; D005374:Filtration / Q000295:instrumentation; D006358:Hot Temperature; D006801:Humans; D006813:Humidity; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D012119:Respiration; D014139:Tracheostomy / Q000295:instrumentation*