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

Acta Otolaryngol. 2010 Jun;130(6):739-46. doi: 10.3109/00016480903382790.

Abstract

Conclusion: 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.

Objectives: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bacteria*
  • Feasibility Studies
  • Female
  • Heating*
  • Humans
  • Humidity*
  • Laryngectomy*
  • Male
  • Micropore Filters*
  • Middle Aged
  • Postoperative Complications / physiopathology*
  • Prospective Studies
  • Static Electricity*
  • Trachea / physiopathology*
  • Tracheostomy / instrumentation*
  • Viruses*