Almajali Omar, Balk Matthias, Rupp Robin, Allner Moritz, Sievert Matti, Iro Heinrich, Schützenberger Anne, Gostian Antoniu-Oreste
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Erlangen, Germany.
Ear Nose Throat J. 2023 Sep 29:1455613231200769. doi: 10.1177/01455613231200769.
To evaluate the effects of a new generation of heat and moisture exchangers (NG-HMEs) on pulmonary rehabilitation, quality of life, patient satisfaction, and usage patterns. A prospective observational study on 23 laryngectomized patients with prior HME experience from June 1, 2021 to November 30, 2021. Patients were interviewed at inclusion, after 6 weeks and after 12 weeks after the introduction of NG-HMEs. Two validated questionnaires were used to report pulmonary complaints and quality of life: the Cough and Sputum Assessment Questionnaire (CASA-Q), the European Quality of Life 5 Dimensions Index Score (EQ-5D Index Score), and the European Quality of Life 5 Dimensions Visual Analog Scale (EQ-5D-VAS). Usage patterns and patient satisfaction were reported using study-specific questionnaires. The patients had an average age of 65.7 ± 6.8 years, with 87% being male, on average 33.7 ± 35.3 months after total laryngectomy (TLE). NG-HMEs were used for a mean of 21.87 ± 4.63 hours/day ( = .034). After 12 weeks of use, patients reported the following changes in the CASA-Q domains: cough symptoms (+5; = .663), cough impact (0; = .958), sputum symptoms (+8; = .13), and sputum impact (+3; = .489). The EQ-5D index score increased (+0.024; = .917) as well as the EQ-5D VAS (+0.8; = .27). All patients rated their experience with NG-HMEs with ≥3 out of 5. The patients who used NG-HMEs as instructed (n = 13) reported more profound changes in the CASA-Q domains: cough symptom (+11; = .129), cough impact (+7; = .209), sputum symptom (+11; = .123), and sputum impact (+10; = .102). Our results show that NG-HMEs could have a positive clinical impact on pulmonary rehabilitation after TLE, even in HME-experienced patients. The use of NG-HMEs does not affect the quality of life. The possible effects of NG-HMEs require further evaluation in long-term studies to fully assess their efficacy.
评估新一代热湿交换器（NG-HMEs）对肺康复、生活质量、患者满意度和使用模式的影响。对23例有热湿交换器使用经验的喉切除患者进行前瞻性观察研究，研究时间为2021年6月1日至2021年11月30日。在纳入研究时、引入NG-HMEs后6周和12周对患者进行访谈。使用两份经过验证的问卷来报告肺部不适和生活质量：咳嗽与痰液评估问卷（CASA-Q）、欧洲生活质量5维度指数评分（EQ-5D指数评分）和欧洲生活质量5维度视觉模拟量表（EQ-5D-VAS）。使用特定研究问卷报告使用模式和患者满意度。患者平均年龄为65.7±6.8岁，87%为男性，全喉切除（TLE）后平均33.7±35.3个月。NG-HMEs平均每天使用21.87±4.63小时（P = 0.034）。使用12周后，患者报告CASA-Q各领域有以下变化：咳嗽症状（+5；P = 0.663）、咳嗽影响（0；P = 0.958）、痰液症状（+8；P = 0.13）和痰液影响（+3；P = 0.489）。EQ-5D指数评分增加（+0.024；P = 0.917），EQ-5D VAS也增加（+0.8；P = 0.27）。所有患者对NG-HMEs体验的评分均≥3分（满分5分）。按照指示使用NG-HMEs的患者（n = 13）报告CASA-Q各领域有更显著变化：咳嗽症状（+11；P = 0.129）、咳嗽影响（+7；P = 0.209）、痰液症状（+11；P = 0.123）和痰液影响（+10；P = 0.102）。我们的结果表明，即使在有热湿交换器使用经验的患者中，NG-HMEs对全喉切除术后的肺康复也可能有积极的临床影响。使用NG-HMEs不影响生活质量。NG-HMEs的可能效果需要在长期研究中进一步评估，以全面评估其疗效。
