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

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Title: The Shikani HME: A New Tracheostomy Heat and Moisture Exchanger.
Authors: Shikani, Alan H.1,2, Elamin, Elamin M.3, Miller, Andrew C.4 Taqwa1@gmail.com
Source: Journal of Speech, Language & Hearing Research. Sep2020, Vol. 63 Issue 9, p2921-2929. 9p. 2 Color Photographs, 2 Diagrams, 2 Charts, 3 Graphs.
Subject Terms: *Voice disorders, *Longitudinal method, *Data analysis, Tracheotomy equipment, Humidity control equipment, Air filters, Airway (Anatomy), Respiratory therapy equipment, Tracheotomy, Analysis of variance, Confidence intervals, Humidity, Mathematical statistics, Scientific observation, Paired comparisons (Mathematics), Respiration, Respiratory measurements, Statistics, Parameters (Statistics), Statistical significance, Repeated measures design, Data analysis software, Descriptive statistics
Abstract: 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 (Rairflow) 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 Rairflow 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 Rairflow, 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: Rairflow was significantly less for the S-HME than M-HME (T0 and T24). Rairflow of the SSV + S-HME in series did not significant increase Rairflow 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. [ABSTRACT FROM AUTHOR]
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Database: Education Research Complete
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Abstract: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 (Rairflow) 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 Rairflow 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 Rairflow, 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: Rairflow was significantly less for the S-HME than M-HME (T0 and T24). Rairflow of the SSV + S-HME in series did not significant increase Rairflow 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. [ABSTRACT FROM AUTHOR]
ISSN:10924388
DOI:10.1044/2020_JSLHR-19-00107