title: Influence of breathing resistance of heat and moisture exchangers on tracheal climate and breathing pattern in laryngectomized individuals.
abstract: BACKGROUND
  The aim of this study was to determine the influence of breathing resistance of heat and moisture exchangers (HMEs) on endotracheal climate and breathing pattern.
  
  
  METHODS
  Endotracheal temperature and humidity and tidal volumes were measured in 11 laryngectomized patients with a regularly used HME with "standard" breathing resistance (Provox Normal HME; R-HME), a low breathing-resistance HME (Provox HiFlow HME; L-HME), and without HME.
  
  
  RESULTS
  Both R-HME and L-HME increased end-inspiratory humidity (+5.8 and 4.7 mgH(2)O/L, respectively), decreased end-inspiratory temperature (-1.6 and -1.0 degrees C, respectively), and prolonged the exhalation breath length to approximately 0.5 seconds. The R-HME significantly enlarged tidal volumes (0.07 L; p < .05).
  
  
  CONCLUSIONS
  Both HMEs significantly improve tracheal climate. The R-HME has better moistening properties and a small but significant positive effect on tidal volume. Therefore, if the higher resistance is tolerated, the R-HME is the preferred pulmonary rehabilitation device. The L-HME is indicated if lower breathing resistance is required.
authors: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors: Renske J
authors: RJ
authors: Scheenstra
authors: Sara H
authors: SH
authors: Muller
authors: Andrew
authors: A
authors: Vincent
authors: Michiel
authors: M
authors: Sinaasappel
authors: Frans J M
authors: FJ
authors: Hilgers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000403:Airway Resistance / Q000502:physiology*; D001831:Body Temperature; D004867:Equipment Design; D005260:Female; D006801:Humans; D006813:Humidity; D007822:Laryngeal Neoplasms / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D007825:Laryngectomy / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D012138:Respiratory Therapy / Q000295:instrumentation*; D013990:Tidal Volume / Q000502:physiology; D014132:Trachea / Q000503:physiopathology*; D016896:Treatment Outcome