Adherencia crónica al humidificador de traqueostoma en pacientes laringectomizados / Chronic adherence to heat and moisture exchanger use in laryngectomized patients

Introducción y objetivos: La laringectomía total implica alteraciones en el sistema respiratorio como el aumento de las secreciones, la expectoración forzada y la tos. El humidificador de traqueostoma (Provox® HME) pretende minimizar estos efectos. El objetivo de este trabajo es valorar la adherencia a su uso crónico en pacientes laringectomizados. Pacientes y métodos: Se ha realizado un estudio prospectivo en 115 pacientes laringectomizados en nuestro centro durante el período 2005-2011. Resultados: De los 115 pacientes, 90 (78,2%) utilizaron el humidificador de traqueostoma de forma habitual, en tanto que 25 (21,8%) abandonaron su uso. Las causas más frecuentes del abandono fueron la no adherencia del parche por la mucosidad y los problemas dermatológicos. De los 30 pacientes portadores de prótesis fonatoria, el 90% utilizaron el sistema HME de forma habitual. La utilización de prótesis fonatoria (p = 0,05) y la indicación primaria en el postoperatorio de la laringectomía (p = 0,0001) fueron factores que se relacionaron de forma significativa con el uso crónico del sistema HME. Conclusiones: Existe una alta adherencia (78,2%) al uso crónico con el humidificador de traqueostoma (Provox® HME) en pacientes laringectomizados. La adherencia crónica al sistema HME es mayor en el grupo de pacientes con indicación primaría y en el de prótesis fonatoria. Las principales causas de abandono se relacionan con la adhesión del parche (AU)

Introduction and objective: Total laryngectomy leads to pulmonary problems such as excessive sputum production, forced expectoration and increased coughing. The use of a heat and moisture exchanger (Provox® HME) reduces these symptoms. The aim of this study was to quantify chronic adherence to HME use in laryngectomized patients. Methods: A prospective study of 115 patients laryngectomized at our centre during 2005-2011 was performed. Results: Of the 115 patients, 90 (78.2%) used the HME consistently and 25 (21.8%) abandoned its use. The most common causes of desertion were adhesion problems due to mucus and skin irritation. Of the 30 patients with voice prostheses, 90% of them used the HME system regularly. Voice prosthesis use (P=0.05) and early indication in postoperative laryngectomy (P=0.001) were factors significantly associated with chronic HME use. Conclusions: There is high adherence (78.2%) to heat and moisture exchanger (Provox® HME) use in laryngectomized patients. Chronic HME use was higher in patients with voice prosthesis and the ones with early indication in postoperative period. The major causes of abandonment were related to problems with the adhesive (AU)

Chronic adherence to heat and moisture exchanger use in laryngectomized patients.

INTRODUCTION AND OBJECTIVE: Total laryngectomy leads to pulmonary problems such as excessive sputum production, forced expectoration and increased coughing. The use of a heat and moisture exchanger (Provox(®) HME) reduces these symptoms. The aim of this study was to quantify chronic adherence to HME use in laryngectomized patients. METHODS: A prospective study of 115 patients laryngectomized at our centre during 2005-2011 was performed. RESULTS: Of the 115 patients, 90 (78.2%) used the HME consistently and 25 (21.8%) abandoned its use. The most common causes of desertion were adhesion problems due to mucus and skin irritation. Of the 30 patients with voice prostheses, 90% of them used the HME system regularly. Voice prosthesis use (P=.05) and early indication in postoperative laryngectomy (P=.001) were factors significantly associated with chronic HME use. CONCLUSIONS: There is high adherence (78.2%) to heat and moisture exchanger (Provox(®) HME) use in laryngectomized patients. Chronic HME use was higher in patients with voice prosthesis and the ones with early indication in postoperative period. The major causes of abandonment were related to problems with the adhesive.