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Tuesday, August 13, 2013

Long-term use of Heat-Moisture Exchangers (HMEs) among laryngectomees: medical, social and psychological patterns

A study published in 2013 by Brook et al. evaluated the long-term use of HMEs and other accessories by laryngectomized patient and especially on the use of the Provox® Micron.

 After laryngectomy, pulmonary protection is mostly acquired by means of using a Heat and Moisture Exchanger (HME) that is placed on an airtight seal around the stoma. The effects of HMEs on tracheal climate have been well-described, and the filtration effect of an HME with electrostatic filter has been described . 
This study investigated long-term use of HMEs in laryngectomees. A questionnaire was sent to 195 laryngectomees of which 75 were returned. Over 85% of all respondents used an HME, of which 77% were compliant users (i.e. >20 hrs/day). Incidence of pulmonary illnesses (either prior of post-surgery) was about 25%. Over 90% of all respondents were heavy smokers prior to their laryngectomy. One-third of all respondents are regularly exposed to dusty environments. Compliant HME-users tend to use less external humidifiers and vaporizers, showing a better pulmonary status and less health-care costs. Regarding Quality of Life, patients using a FreeHands device tended to have the most social contacts (r=.251; p=.030).The prevalence of depression is high, pointing to an urgent need to recognize and treat psychiatric problems like depression and suicidal ideation in this patient group.

Provox® Micron HME

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