title: Comparative ex vivo study on humidifying function of three speaking valves with integrated heat and moisture exchanger for tracheotomised patients.
abstract: OBJECTIVE
  Assessment of humidifying function of tracheotomy speaking valves with integrated heat and moisture exchanger.
  
  
  METHODS
  Ex vivo measurement of water exchange and storage capacity of three tracheotomy speaking valves: Humidiphon Plus, Spiro and ProTrach DualCare (with two different heat and moisture exchangers: XtraMoist and Regular).
  
  
  METHODS
  Comprehensive Cancer Centre.
  
  
  METHODS
  Healthy volunteer.
  
  
  METHODS
  Difference between end-inspiratory and end-expiratory weight as measure for water exchange capacity, weight after 10 min breathing as measure for water storage capacity, weighing at 1-min intervals to assess residual water exchange potential in speaking mode and absolute humidity in mg/L as measure for environmental and respiratory humidity.
  
  
  RESULTS
  None of the tracheotomy speaking valves provides humidification while in speaking mode. Only the ProTrach DualCare allows blocking the speaking valve and breathing through the heat and moisture exchanger during inhalation and exhalation (heat and moisture exchanger mode). This leads to an increase in inspiratory humidity of 2.5 mg (XtraMoist) and 1.6 mg (Regular). There was no measurable water storage in speaking mode in any of the three tracheotomy speaking valves. In breathing mode, water storage in the DualCare heat and moisture exchangers was 47 and 37 mg, respectively. The remaining humidifying potential in speaking mode after 10 min breathing in heat and moisture exchanger mode for XtraMoist was 38%, 15% and 10% at 1, 2 and 3 min, respectively. For Regular, this was 47%, 24% and 13%, respectively.
  
  
  CONCLUSIONS
  Tracheostoma valves with integrated heat and moisture exchanger have no humidification function in speaking mode. Only ProTrach DualCare, allowing blocking the speaking mode, in heat and moisture exchanger mode enables a significant increase in humidification. Regular switching between speaking and heat and moisture exchanger mode with this latter device prolongs the humidification in speaking mode.
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
authors.forename: C
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: L
authors.initials: L
authors.lastname: Lansaat
authors.affiliation: Department of Clinical Physics and Instrumentation, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
authors.forename: S H
authors.initials: SH
authors.lastname: Muller
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, Amsterdam, The Netherlands.|Department of Oral-Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: M 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, Amsterdam, The Netherlands.
authors.forename: F J M
authors.initials: FJ
authors.lastname: Hilgers
mesh_terms: D004867:Equipment Design; D045853:Exhalation / Q000502:physiology*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D006813:Humidity; D007825:Laryngectomy / Q000534:rehabilitation*; D008297:Male; D013060:Speech / Q000502:physiology*; D013061:Speech Acoustics; D014139:Tracheostomy / Q000295:instrumentation*; D017155:Wettability