热湿交换器呼吸阻力对喉切除患者气管气候和呼吸模式的影响。
Influence of breathing resistance of heat and moisture exchangers on tracheal climate and breathing pattern in laryngectomized individuals.
机构信息
Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
出版信息
Head Neck. 2010 Aug;32(8):1069-78. doi: 10.1002/hed.21293.
BACKGROUND
The aim of this study was to determine the influence of breathing resistance of heat and moisture exchangers (HMEs) on endotracheal climate and breathing pattern.
METHODS
Endotracheal temperature and humidity and tidal volumes were measured in 11 laryngectomized patients with a regularly used HME with "standard" breathing resistance (Provox Normal HME; R-HME), a low breathing-resistance HME (Provox HiFlow HME; L-HME), and without HME.
RESULTS
Both R-HME and L-HME increased end-inspiratory humidity (+5.8 and 4.7 mgH(2)O/L, respectively), decreased end-inspiratory temperature (-1.6 and -1.0 degrees C, respectively), and prolonged the exhalation breath length to approximately 0.5 seconds. The R-HME significantly enlarged tidal volumes (0.07 L; p < .05).
CONCLUSIONS
Both HMEs significantly improve tracheal climate. The R-HME has better moistening properties and a small but significant positive effect on tidal volume. Therefore, if the higher resistance is tolerated, the R-HME is the preferred pulmonary rehabilitation device. The L-HME is indicated if lower breathing resistance is required.
背景
本研究旨在确定热和湿气交换器（HME）的呼吸阻力对气管内气候和呼吸模式的影响。
方法
对 11 例全喉切除患者进行了测量，使用常规 HME（具有“标准”呼吸阻力的 Provox Normal HME；R-HME）、低呼吸阻力 HME（Provox HiFlow HME；L-HME）和无 HME 的气管内温度和湿度以及潮气量。
结果
R-HME 和 L-HME 均增加了吸气末湿度（分别增加了 5.8 和 4.7mgH2O/L），降低了吸气末温度（分别降低了 1.6 和 1.0 摄氏度），并延长了呼气呼气长度约 0.5 秒。R-HME 显著增加了潮气量（0.07L；p<.05）。
结论
两种 HME 均显著改善了气管内气候。R-HME 具有更好的加湿性能，对潮气量有微小但显著的积极影响。因此，如果可以耐受更高的阻力，则 R-HME 是首选的肺康复设备。如果需要较低的呼吸阻力，则需要使用 L-HME。
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