Purpose Tracheostomy patients face many adversities including loss of phonation and essential airway functions including air filtering, warming, and humidification. Heat and moisture exchangers (HMEs) facilitate humidification and filtering of inspired air. The Shikani HME (S-HME) is a novel turbulent airflow HME that may be used in-line with the Shikani Speaking Valve (SSV), allowing for uniquely preserved phonation during humidification. The aims of this study were to (a) compare the airflow resistance ( R airflow ) and humidification efficiency of the S-HME and the Mallinckrodt Tracheolife II tracheostomy HME (M-HME) when dry (time zero) and wet (after 24 hr) and (b) determine if in-line application of the S-HME with a tracheostomy speaking valve significantly increases R airflow over a tracheostomy speaking valve alone (whether SSV or Passy Muir Valve [PMV]). Method A prospective observational ex vivo study was conducted using a pneumotachometer lung simulation unit to measure airflow ( Q ) amplitude and R airflow , as indicated by a pressure drop ( P Drop ) across the device (S-HME, M-HME, SSV + S-HME, and PMV). Additionally, P Drop was studied for the S-HME and M-HME when dry at time zero (T 0 ) and after 24 hr of moisture testing (T 24 ) at Q of 0.5, 1, and 1.5 L/s. Results R airflow was significantly less for the S-HME than M-HME (T 0 and T 24 ). R airflow of the SSV + S-HME in series did not significant increase R airflow over the SSV or PMV alone. Moisture loss efficiency trended toward greater efficiency for the S-HME; however, the difference was not statistically significant. Conclusions The turbulent flow S-HME provides heat and moisture exchange with similar or greater efficacy than the widely used laminar airflow M-HME, but with significantly lower resistance. The S-HME also allows the innovative advantage of in-line use with the SSV, hence allowing concurrent humidification and phonation during application, without having to manipulate either device.

中文翻译：

---

Shikani HME：新型气管切开热湿交换器

目的气管切开术患者面临许多逆境，包括失去发声和基本气道功能，包括空气过滤、加温和加湿。热湿交换器 (HME) 有助于加湿和过滤吸入的空气。Shikani HME (S-HME) 是一种新颖的湍流气流 HME，可与 Shikani 发声阀 (SSV) 串联使用，从而在加湿过程中独特地保留发声。本研究的目的是 (a) 比较气流阻力（右 空气流动) 和干燥（零时间）和湿润（24 小时后）时 S-HME 和 Mallinckrodt Tracheolife II 气管切开术 HME (M-HME) 的加湿效率，以及 (b) 确定 S-HME 是否在线应用气管造口术说话瓣膜显着增加右 空气流动单独使用气管造口瓣膜（无论是 SSV 还是 Passy Muir Valve [PMV]）。 方法使用呼吸速度计肺模拟装置测量气流进行了前瞻性观察性离体研究（问) 幅度和右 空气流动，如压降所示（磷 降低）跨设备（S-HME、M-HME、SSV + S-HME 和 PMV）。此外，磷 降低研究了零时间干燥时的 S-HME 和 M-HME（T0）和 24 小时湿度测试后（T24） 在问0.5、1 和 1.5 升/秒。 结果 右 空气流动S-HME 的显着低于 M-HME（T0和T24）。右 空气流动SSV+S-HME串联数量没有明显增加右 空气流动单独通过 SSV 或 PMV。S-HME 的水分损失效率趋向于提高效率；然而，差异没有统计学意义。 结论湍流 S-HME 提供热量和水分交换，其效率与广泛使用的层流气流 M-HME 相似或更高，但阻力显着降低。S-HME 还具有与 SSV 串联使用的创新优势，因此可以在应用过程中同时进行加湿和发声，而无需操作任何一个设备。