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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]
Copyright of Journal of Speech, Language & Hearing Research is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: The Shikani HME: A New Tracheostomy Heat and Moisture Exchanger.
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  Data: <searchLink fieldCode="AR" term="%22Shikani%2C+Alan+H%2E%22">Shikani, Alan H.</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Elamin%2C+Elamin+M%2E%22">Elamin, Elamin M.</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Miller%2C+Andrew+C%2E%22">Miller, Andrew C.</searchLink><relatesTo>4</relatesTo><i> Taqwa1@gmail.com</i>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Speech%2C+Language+%26+Hearing+Research%22">Journal of Speech, Language & Hearing Research</searchLink>. Sep2020, Vol. 63 Issue 9, p2921-2929. 9p. 2 Color Photographs, 2 Diagrams, 2 Charts, 3 Graphs.
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  Data: *<searchLink fieldCode="DE" term="%22Voice+disorders%22">Voice disorders</searchLink><br />*<searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br />*<searchLink fieldCode="DE" term="%22Data+analysis%22">Data analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Tracheotomy+equipment%22">Tracheotomy equipment</searchLink><br /><searchLink fieldCode="DE" term="%22Humidity+control+equipment%22">Humidity control equipment</searchLink><br /><searchLink fieldCode="DE" term="%22Air+filters%22">Air filters</searchLink><br /><searchLink fieldCode="DE" term="%22Airway+%28Anatomy%29%22">Airway (Anatomy)</searchLink><br /><searchLink fieldCode="DE" term="%22Respiratory+therapy+equipment%22">Respiratory therapy equipment</searchLink><br /><searchLink fieldCode="DE" term="%22Tracheotomy%22">Tracheotomy</searchLink><br /><searchLink fieldCode="DE" term="%22Analysis+of+variance%22">Analysis of variance</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Humidity%22">Humidity</searchLink><br /><searchLink fieldCode="DE" term="%22Mathematical+statistics%22">Mathematical statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Scientific+observation%22">Scientific observation</searchLink><br /><searchLink fieldCode="DE" term="%22Paired+comparisons+%28Mathematics%29%22">Paired comparisons (Mathematics)</searchLink><br /><searchLink fieldCode="DE" term="%22Respiration%22">Respiration</searchLink><br /><searchLink fieldCode="DE" term="%22Respiratory+measurements%22">Respiratory measurements</searchLink><br /><searchLink fieldCode="DE" term="%22Statistics%22">Statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Parameters+%28Statistics%29%22">Parameters (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+significance%22">Statistical significance</searchLink><br /><searchLink fieldCode="DE" term="%22Repeated+measures+design%22">Repeated measures design</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Journal of Speech, Language & Hearing Research is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1044/2020_JSLHR-19-00107
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 9
        StartPage: 2921
    Subjects:
      – SubjectFull: Voice disorders
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Data analysis
        Type: general
      – SubjectFull: Tracheotomy equipment
        Type: general
      – SubjectFull: Humidity control equipment
        Type: general
      – SubjectFull: Air filters
        Type: general
      – SubjectFull: Airway (Anatomy)
        Type: general
      – SubjectFull: Respiratory therapy equipment
        Type: general
      – SubjectFull: Tracheotomy
        Type: general
      – SubjectFull: Analysis of variance
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Humidity
        Type: general
      – SubjectFull: Mathematical statistics
        Type: general
      – SubjectFull: Scientific observation
        Type: general
      – SubjectFull: Paired comparisons (Mathematics)
        Type: general
      – SubjectFull: Respiration
        Type: general
      – SubjectFull: Respiratory measurements
        Type: general
      – SubjectFull: Statistics
        Type: general
      – SubjectFull: Parameters (Statistics)
        Type: general
      – SubjectFull: Statistical significance
        Type: general
      – SubjectFull: Repeated measures design
        Type: general
      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
    Titles:
      – TitleFull: The Shikani HME: A New Tracheostomy Heat and Moisture Exchanger.
        Type: main
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            NameFull: Shikani, Alan H.
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            NameFull: Elamin, Elamin M.
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            NameFull: Miller, Andrew C.
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          Dates:
            – D: 01
              M: 09
              Text: Sep2020
              Type: published
              Y: 2020
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              Value: 63
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            – TitleFull: Journal of Speech, Language & Hearing Research
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