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열가습 여과기로 치료한 후두전적출 환자의 난치성 기관염 1예

A Case of Intractable Tracheitis Treated by Heat-Moisture Exchangers in a Total Laryngectomized Patient

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초록

The tracheostomy directs external air into the airway tract. This process causes mucosal dryness, irritation and inflammation in the tracheo-bronchial tree. In order to prevent such problems, several methods are applied; ointment application, humidification and careful suction etc. The heat-moisture exchanger (HME) is commercially sold device that assists heating and humidification of the inhaled air. The authors experienced successful treatment outcome of intractable tracheitis caused by repetitive and vigorous intra-tracheal suction by applying HME in a total laryngectomized patient. We report an interesting and didactic case with a brief literature review.

Abstract

The tracheostomy directs external air into the airway tract. This process causes mucosal dryness, irritation and inflammation in the tracheo-bronchial tree. In order to prevent such problems, several methods are applied; ointment application, humidification and careful suction etc. The heat-moisture exchanger (HME) is commercially sold device that assists heating and humidification of the inhaled air. The authors experienced successful treatment outcome of intractable tracheitis caused by repetitive and vigorous intra-tracheal suction by applying HME in a total laryngectomized patient. We report an interesting and didactic case with a brief literature review.

참고문헌 (9)

  1. Brook I, "The challenges of treating tracheobronchitis in a laryngectomee due to nontypeable Haemophilus influenzae : a case report", J Med Case Rep, 12(1), pp.242~ (2018)
  2. Inui D, "Effect of heat and moisture exchanger(HME)positioning on inspiratory gas humidification", BMC Pulm Med, 6, pp.19~ (2006)
  3. Nakanishi N, "Humidification performance of passive and active humidification devices within a spontaneously breathing tracheostomized cohort", Respir Care, 64(2), pp.130~135 (2019)
  4. Iotti GA, "Mechanical effects of heat-moisture exchangers in ventilated patients", Crit Care, 3(5), pp.R77~R82 (1999)
  5. Scheenstra RJ, "A new heat and moisture exchanger for laryngectomized patients : endotracheal temperature and humidity", Respir Care, 56(5), pp.604~611 (2011)
  6. Retèl VP, "Cost-effectiveness of heat and moisture exchangers compared to usual care for pulmonary rehabilitation after total laryngectomy in Poland", Eur Arch Otorhinolaryngol, 272(9), pp.2381~2388 (2015)
  7. van den Boer C, "Effects of heat and moisture exchangers on tracheal mucociliary clearance in laryngectomized patients : a multi-center case-control study", Eur Arch Otorhinolaryngol, 272(11), pp.3439~3450 (2015)
  8. Macri GF, "Patients’ experiences with HMEs and attachments after total laryngectomy", Clin Otolaryngol, 41(6), pp.652~659 (2016)
  9. Palav R, "Role of heat moist exchanger in pulmonary rehabilitation after total-laryngectomy", Bombay Hosp J, 53(4), pp.735~742 (2011)

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