The effect of a Heat and Moisture Exchanger (Provox® HME) on pulmonary protection after total laryngectomy: a randomized controlled study

Abstract

The goal of this randomized controlled study was to investigate the effect of Heat and Moisture Exchanger use on pulmonary symptoms and quality of life aspects in laryngectomized patients. Eighty laryngectomized patients were included and randomized into an HME and Control group. The effect of the HME was evaluated by means of Tally Sheets and Structured Questionnaires. The results showed a significant decrease in the frequency of coughing, forced expectoration, and stoma cleaning in the HME group. There were trends for the prosthetic speakers to report more fluent speech with the HME and for the HME group to report fewer sleeping problems. In conclusion, this study, performed in Poland, confirms the results of previous studies performed in other countries, showing that pulmonary symptoms decrease significantly with HME use and that related aspects such as speech and sleeping tend to improve, regardless of country or climate.

Trocador de calor e umidade: proteção contra infecções pulmonares? Estudo piloto

“…Estudos mostram que a PAV é principalmente decorrente da aspiração de conteúdos orofaríngeos do paciente [23][24][25] . Outra fonte é a inalação de aerossol contaminado, já que em pacientes intubados a do TOT elimina a proteção natural das vias aéreas permitindo, assim, acesso direto ao trato respiratório inferior 24 . O risco de PAV secundária à contaminação do circuito tem sido estimado em menos de 5% e, portanto, sua troca constante para prevenção não é necessária 26 .…”

“…Segundo a literatura, os mais comuns são Pseudomonas aeruginosa, espécies de Acinetobacter e Staphilococcus aureus resistentes à Meticilina 5,7,11,28 , assim como verificamos em nosso estudo. Embora bacillus gram negativo não sejam frequentes na cultura faríngea de pessoas saudáveis, a colonização cresce rapidamente em pacientes em coma, com hipotensão, leucocitose, leucopenia, doenças pulmonares, presença de TOT ou sonda nasogástrica e em pacientes recebendo antibióticos 20,21,24 . No grupo estudado, realizou-se troca do FTCU a cada 24 horas, como recomendado pelos fabricantes.…”

A Novel, Simplified Ex Vivo Method for Measuring Water Exchange Performance of Heat and Moisture Exchangers for Tracheostomy Application

“…5,6 Use of an HME after laryngectomy has proven to significantly reduce pulmonary complaints and to improve quality of life. 4,[7][8][9] Therefore, these medical devices are currently considered as mandatory therapeutic and rehabilitative measures for laryngectomized patients.…”

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

“…Potentially, this could be achieved with a so‐called heat and moisture exchanger (HME). Extensive clinical research, including several randomized clinical trials, has shown that HMEs have a positive influence on the aforementioned bothersome pulmonary problems and also improve quality of life and voice 7–10. Moreover, it could be shown that by starting the use of HMEs as early as possible after total laryngectomy, these pulmonary problems can be significantly diminished and to some extent also prevented 11, 12.…”