Heat and moisture exchanger cassettes: Results of a quality/safety initiative to reduce postoperative mucus plugging after total laryngectomy

Head Neck. 2020 Sep;42(9):2453-2459. doi: 10.1002/hed.26267. Epub 2020 May 23.

Abstract

Background: Tracheal dryness is a concern after total laryngectomy due to the potential for mucus plugs (MP). This study compared heat and moisture exchanger (HME) cassettes to external tracheal humidification (ETH) surrounding MP events.

Methods: A retrospective comparative cohort study comparing outcomes before/after implementation of a patient safety initiative utilizing HME during post laryngectomy hospitalization. The number of MP events were compared with a pre-implementation control group using ETH. Patient characteristics were analyzed for correlation with MP.

Results: The rate of MP was significantly lower in the HME group than ETH (0.13 and 0.38 per 10 inpatient days, respectively, P = .02). The proportion of patients with one or more MP events was also significantly reduced in the HME group (50% ETH and 11% HME, P = .01). Method of humidification was the only significant variable associated with MP on logistic regression modeling (P = .008).

Conclusions: HMEs were superior to ETH for prevention of MP.

Keywords: external tracheal humidification; heat moisture exchanger; laryngectomy; mucus plug; pulmonary rehabilitation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Hot Temperature*
  • Humans
  • Humidity
  • Laryngectomy*
  • Mucus
  • Retrospective Studies