The Shikani HME: A New Tracheostomy Heat and Moisture Exchanger.

Purpose: Tracheostomy patients face many adversities including loss of phonation and essential airway functions including air filtering, warming, and humidification. Heat and moisture exchangers (HMEs) facilitate humidification and filtering of inspired air. The Shikani HME (S-HME) is a novel turbul...

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Publicado en:Journal of Speech, Language & Hearing Research Vol. 63; no. 9; pp. 2921 - 2930
Autores principales: Shikani, Alan H., Elamin, Elamin M., Miller, Andrew C.
Formato: Artículo
Publicado: American Speech-Language-Hearing Association Sep2020
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2020
      vid: 63
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      pub: American Speech-Language-Hearing Association
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        10.1044/2020_JSLHR-19-00107
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        atl: The Shikani HME: A New Tracheostomy Heat and Moisture Exchanger.
      aug:
        au:
          Shikani, Alan H.
          Elamin, Elamin M.
          Miller, Andrew C.
        affil:
          Division of Otolaryngology—Head and Neck Surgery, MedStar Union Memorial Hospital, Baltimore, MD.
          Division of Otolaryngology—Head and Neck Surgery, LifeBridge Sinai Hospital, Baltimore, MD.
          Division of Pulmonary, Critical Care Medicine and Sleep, James A. Haley Veteran Hospital, University of South Florida, Tampa.
          Department of Emergency Medicine, Nazareth Hospital, Philadelphia College of Osteopathic Medicine, PA.
      su:
        Analysis of variance
        Parameters (Statistics)
        Tracheotomy equipment
        Humidity control equipment
        Air filters
        Voice disorders
        Airway (Anatomy)
        Respiratory therapy equipment
        Tracheotomy
        Confidence intervals
        Humidity
        Longitudinal method
        Mathematical statistics
        Scientific observation
        Paired comparisons (Mathematics)
        Respiration
        Respiratory measurements
        Statistics
        Data analysis
        Statistical significance
        Repeated measures design
        Data analysis software
        Descriptive statistics
      sug:
        subj:
          Analysis of variance
          Parameters (Statistics)
          Plumbing, Heating, and Air-Conditioning Contractors
          Other Building Equipment Contractors
          Household Appliances, Electric Housewares, and Consumer Electronics Merchant Wholesalers
          Warm Air Heating and Air-Conditioning Equipment and Supplies Merchant Wholesalers
          Heating equipment and commercial refrigeration equipment manufacturing
          Electrical Contractors and Other Wiring Installation Contractors
          Household appliance merchant wholesalers
          Air-Conditioning and Warm Air Heating Equipment and Commercial and Industrial Refrigeration Equipment Manufacturing
          Surgical Appliance and Supplies Manufacturing
          Medical equipment and supplies manufacturing
          Electromedical and Electrotherapeutic Apparatus Manufacturing
          Tracheotomy equipment
          Humidity control equipment
          Air filters
          Voice disorders
          Airway (Anatomy)
          Respiratory therapy equipment
          Tracheotomy
          Confidence intervals
          Humidity
          Longitudinal method
          Mathematical statistics
          Scientific observation
          Paired comparisons (Mathematics)
          Respiration
          Respiratory measurements
          Statistics
          Data analysis
          Statistical significance
          Repeated measures design
          Data analysis software
          Descriptive statistics
      ab: Purpose: Tracheostomy patients face many adversities including loss of phonation and essential airway functions including air filtering, warming, and humidification. Heat and moisture exchangers (HMEs) facilitate humidification and filtering of inspired air. The Shikani HME (S-HME) is a novel turbulent airflow HME that may be used in-line with the Shikani Speaking Valve (SSV), allowing for uniquely preserved phonation during humidification. The aims of this study were to (a) compare the airflow resistance (R) and humidification efficiency of the S-HME and the Mallinckrodt Tracheolife II tracheostomy HME (M-HME) when dry (time zero) and wet (after 24 hr) and (b) determine if in-line application of the S-HME with a tracheostomy speaking valve significantly increases R over a tracheostomy speaking valve alone (whether SSV or Passy Muir Valve [PMV]). Method: A prospective observational ex vivo study was conducted using a pneumotachometer lung simulation unit to measure airflow (Q) amplitude and R, as indicated by a pressure drop (PDrop) across the device (S-HME, M-HME, SSV + S-HME, and PMV). Additionally, PDrop was studied for the S-HME and M-HME when dry at time zero (T0) and after 24 hr of moisture testing (T24) at Q of 0.5, 1, and 1.5 L/s. Results: R was significantly less for the S-HME than M-HME (T0 and T24). R of the SSV + S-HME in series did not significant increase R over the SSV or PMV alone. Moisture loss efficiency trended toward greater efficiency for the S-HME; however, the difference was not statistically significant. Conclusions: The turbulent flow S-HME provides heat and moisture exchange with similar or greater efficacy than the widely used laminar airflow M-HME, but with significantly lower resistance. The S-HME also allows the innovative advantage of in-line use with the SSV, hence allowing concurrent humidification and phonation during application, without having to manipulate either device.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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