Short-term endotracheal climate changes and clinical effects of a heat and moisture exchanger with an integrated electrostatic virus and bacterial filter developed for laryngectomized individuals.
CONCLUSIONS
Both the regularly used heat and moisture exchanger (R-HME) and the HME with both an antimicrobial and hygroscopic element (F-HME) are effective moisture exchangers. The antimicrobial filter of the F-HME acts as a heat exchanger. The external features of the F-HME were experienced as inconvenient, but decreased sputum production was reported as well.


OBJECTIVE
Recently an HME with an integrated antimicrobial filter has become available for use in laryngectomized patients. The purpose of this study was to assess its short-term endotracheal climate changes and feasibility in daily practice.


METHODS
Endotracheal temperature and humidity were successfully measured in 13 laryngectomized patients (2652 analysed full breaths), during 10 min rest-breathing with the R-HME, with an F-HME and without HME in a randomized sequence. Additionally, a 3 week prospective clinical feasibility trial was conducted in 17 laryngectomized patients.


RESULTS
Both R-HME and F-HME increase endotracheal minimum humidity values (5.8 and 4.7 mgH(2)O/L, respectively; p < 0.0001). Compared with open stoma breathing, in contrast to the R-HME, the F-HME increases both end-inspiratory and end-expiratory temperature values (1.1 degrees C, and 0.6 degrees C, respectively). After the 3-week clinical feasibility trial, one patient dropped out; 11 patients (11/16 = 69%) disliked the larger design of the F-HME and all patients reported less optimal airtight occlusion. Five patients (5/16 = 31%) reported remarkably decreased sputum production.
Scheenstra
Renske J
RJ
Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Muller
Sara H
SH
Vincent
Andrew
A
Ackerstaff
Annemieke H
AH
Jacobi
Irene
I
Hilgers
Frans J M
FJ
D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria; D005240:Feasibility Studies; D005260:Female; D006361:Heating; D006801:Humans; D006813:Humidity; D007825:Laryngectomy; D008297:Male; D008851:Micropore Filters; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011446:Prospective Studies; D055672:Static Electricity; D014132:Trachea / Q000503:physiopathology*; D014139:Tracheostomy / Q000295:instrumentation*; D014780:Viruses