title: Water Uptake Performance of Hygroscopic Heat and Moisture Exchangers after 24-Hour Tracheostoma Application.
abstract: After total laryngectomy, patients suffer from pulmonary complaints due to the shortcut of the upper airways that results in decreased warming and humidification of inspired air. Laryngectomized patients are advised to use a heat and moisture exchanger (HME) to optimize the inspired air. According to manufacturers' guidelines, these medical devices should be replaced every 24 hours. The aim of this study is to determine whether HMEs still function after 24-hour tracheostoma application.
  
  
  
  Assessment of residual water uptake capacity of used HMEs by measuring the difference between wet and dry core weight.
  
  
  
  Tertiary comprehensive cancer center.
  
  
  
  Three hygroscopic HME types were tested after use by laryngectomized patients in long-term follow-up. Water uptake of 41 used devices (including 10 prematurely replaced devices) was compared with that of control (unused) devices of the same type and with a control device with a relatively low performance.
  
  
  
  After 24 hours, the mean water uptake of the 3 device types had decreased compared with that of the control devices. For only one type was this difference significant. None of the used HMEs had a water uptake lower than that of the low-performing control device.
  
  
  
  The water uptake capacity of hygroscopic HEMs is clinically acceptable although no longer optimal after 24-hour tracheostoma application. From a functional point of view, the guideline for daily device replacement is therefore justified.
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
authors.forename: Cindy
authors.initials: C
authors.lastname: van den Boer
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Vas Nunes
authors.affiliation: Department of Clinical Physics and Instrumentation, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
authors.forename: Sara H
authors.initials: SH
authors.lastname: Muller
authors.affiliation: Department of Biometrics, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
authors.forename: Vincent
authors.initials: V
authors.lastname: van der Noort
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands Institute of Phonetic Sciences (ACLC), University of Amsterdam, The Netherlands Department of Oral-Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: Michiel W M
authors.initials: MW
authors.lastname: van den Brekel
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands Institute of Phonetic Sciences (ACLC), University of Amsterdam, The Netherlands f.hilgers@nki.nl.
authors.forename: Frans J M
authors.initials: FJ
authors.lastname: Hilgers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006813:Humidity; D058427:Hygroscopic Agents; D006979:Hyperthermia, Induced / Q000295:instrumentation*; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D054047:Surgical Stomas; D013997:Time Factors; D014139:Tracheostomy
chemical_list: D058427:Hygroscopic Agents
keywords: heat and moisture exchanger; humidity; hygroscopic salt; laryngectomy; prospective studies; water exchange