Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: External humidifier versus heat and moisture exchanger

Mérol, J.-C.; Charpiot, Anne; Langagne, T.; Hemar, P.; Ackerstaff, Annemieke H.; Hilgers, Frans J. M.

doi:10.1002/lary.21841

Cited by 40 publications

(66 citation statements)

References 22 publications

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“…excessive sputum production and involuntary coughing). Sleep disturbance is prevalent in these patients [2, 3]. The respiratory problems and poor sleep quality leads to low patients’ satisfaction.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

et al. 2017

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BackgroundDexmedetomidine as an adjunct with opioids has been confirmed to spare opioids usage and improve analgesia for postoperative pain treatment. Furthermore, dexmedetomidine can attenuate the airway reflex. The aim of this study is to assess the safety and efficacy of dexmedetomidine combined with sufentanil for postoperative analgesia after partial laryngectomy.MethodsA total of 60 adult male patients were recruited and randomly allocated to receive sufentanil 1.0 μg ml−1 (Group S) or sufentanil 1.0 μg ml−1 plus dexmedetomidine 4 μg ml−1 (Group SD) for postoperative analgesia. The IV patient controlled analgesia (PCA) device was programmed to deliver 1.5 ml per demand with a 10 min lockout interval and 1.5 ml per hour background infusion. Cumulative consumption of sufentanil and pain intensity during 24 hour (h) after surgery were recorded. Coughing episodes per day, sleep quality, hemodynamic and respiratory profiles were measured.ResultsCompared with Group S, patients in Group SD required less sufentanil during the 0–24 h postoperative period (p < 0.0001) and reported significant lower pain intensity from the second postoperative hour to the end of the study (P < 0.0001). Daily coughing episodes, sleep disturbance was lower and patients’ satisfaction was higher in Group SD (P < 0.05). Decrease in heart rate and mean blood pressure from baseline at 1 h, 2 h, 3 h, 12 h, and 24 h after operation were significantly greater in Group SD (P = 0.00). The incidence of PCA related adverse events were comparable between the two groups.ConclusionDexmedetomidine/sufentanil combination for postoperatjve analgesia in partial laryngectomized patients resulted in significant sufentanil sparing, better analgesia, reduced frequency coughing episodes, and better sleep quality.Trial registrationChinese Clinical Registry (ChiCTR): ChiCTR-TRC-14004618, date of registration: 08 May 2014.

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Section: Introductionmentioning

confidence: 99%

Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

et al. 2017

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“…However, in most of the world and specifically in South Africa, HMEs are not affordable. Annual costs for HMEs conservatively range from the equivalent of U.S. $350 to U.S. $1750 . Consequently, reliance is placed on simpler and inexpensive solutions to improve tracheal climate in patients with laryngectomies.…”

Section: Introductionmentioning

confidence: 99%

Effect of cloth stoma covers on tracheal climate of laryngectomy patients

et al. 2015

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“…17 A more recent study in laryngectomized adult patients found better cough and adherence to HME than to HH in the immediate postoperative period. 18 The humidifier in that study did not use heated tubing, which may have resulted in condensate, potentially affecting outcomes. In the long-term study we also documented significantly fewer lower-respiratory-tract infections, acute respiratory admissions, tracheostomy tube occlusions/emergency changes, and treatment failures during the HH period.…”

Section: Discussionmentioning

confidence: 94%

Heated Humidification Improves Clinical Outcomes, Compared to a Heat and Moisture Exchanger in Children With Tracheostomies

et al. 2013

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BACKGROUND:The upper airway humidifies and warms inspired gases before they reach the trachea, a process bypassed by the insertion of a tracheostomy, necessitating humidification of inspired gases. The optimal method of humidification is not known. METHODS: We conducted a short-term 20-hour study and a long-term 10-week randomized crossover study comparing a heated humidifier (HH) to a heat and moisture exchanger (HME) in children with established tracheostomies. Subjects were assessed for clinical events, clinical examination findings, airway cytokine levels, and airway secretion viscoelasticity. RESULTS: For the short-term study, 15 children were recruited; for the long-term study, 14 children were recruited. Children using the HH had decreased respiratory examination score (P < .001) but no change in clinical events over the short term. There was a decrease in acute clinical events (P ‫؍‬ .008) in the long-term study. No differences were found in airway secretion viscoelasticity results or cytokine levels in either study, but these sample numbers were limited. CONCLUSIONS: Over 20 hours use, HH, compared to HME, improved work of breathing. Over a longer 10 week treatment period HH resulted in decreased adverse clinical events.

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Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: External humidifier versus heat and moisture exchanger

Abstract: This RCT clearly shows the benefits of immediate postoperative airway humidification by means of an HME over the use of an EH after TLE. This study therefore underlines that HMEs presently can be considered the better option for early postoperative airway humidification after TLE.

Cited by 40 publications

References 22 publications

Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

Effect of cloth stoma covers on tracheal climate of laryngectomy patients

Heated Humidification Improves Clinical Outcomes, Compared to a Heat and Moisture Exchanger in Children With Tracheostomies

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